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To: City of Santa Ana From: Laura Baron 6-30-08 10:50am p. 2 of 6 Ili,tiooC-g � b� ACORD,M CERTIFICATE OF LIABILITY INSURANCE DATE/0/2008 IYYYV) PRODUCER Garrett/Mosier/Griffith/Sistrunk Ins. Services THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 12 Truman ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Irvine, CA 92620 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (949)559-6700 A-2008-215 www garrett-mosier.com OB84519 INSURERS AFFORDING COVERAGE NAIC # INSURED Ken Thompson, Inc. INSURER A Old Republic General Insurance Corp JSURER e. ----------- r1785 Sampson Avenue asuaER _ — -- Corona, CA 92879 1 NS-JRER. E MVFRAnFR THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR OO L POLICY NUMBER POLICY EFFEG7IYE DATE MMIDDIYY POLICY EXPIRATION DATE MMIDDIYY LIMITS A GENERAL LIABILITY EA HOCCURRENCE $ 1,000,000 GENERALL,A_RL1-- AlCG89970800 2/13/2008 2/13/2009 '�p,RA" sEsfEaoccuren� $ 300,000 ^LpJMS MArCE r ^r,q MEN Exp (Any one pe-san) $ 10,000 PERSONAL &A J_PY 1,000,000 GENERAL EGATE $ 2,000,000 Al R .ATE L MI .I ES PER F C 1_ _l, _ M a,_ O 2,000,000 ! /4 PR, o�l,,: A AUTOMOBILE LIVABILITY a^r A T A1CA89970800 2/13/2008 2/13l2009 1111f ED81 n - _IM7 a Ide r 1,000 000 Ai C VkN, C AI;-C S �—{ h'E R $ fFe ':UHF LLED :;LTOS � � person)on) i 6:. 1 hJ JliRv $ iIRED AL O5 II i PJCN r 'ED AUTOS (FP a Idant) FERTYD�AMA;=F ;Fer acaderti I $ GARAGE LIABILITY �. AJ J,NC==-EA ACr'CE'1l I$ $ i fUdY AUTO ' � THAN =AACC EXC ESSIUMBRELL LIABILITY EACH OCCJRRENCE $ h IF �A � C'..AiMo[r`ADE I, _rgTE �3 I I I RE-ENT:O:V $ $ WORKERS COMPENSATION AND Y �TATU I0-H- T qJ LIfJ4 SI FA 1 A EMPLOYERS' LIABILITY Al CW89970800 6/30/2008 6/30/2009 1,000,000 IA a�_ AJN Di -.FACE_ AEMFLOIEE:� q 1,000000 OFF RI9 t.'8ERE CLJDEE? Ifys d s belria YE-L EASE-P__iCvJMI` E� g $1,000,000 RPE 4 PR._ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS t VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RE: Raitt/McFadden Sanitary Sewer Improvements The City of Santa Ana, its Officers. Employees, Agents, Volunteers and Representatives Additional Insured are added as per CG20100704 and CG20370704 and this insurance Is primary per CGENGN00290906 attached, with respect to work perform for them by Ken Thompson, Inc. under General Liability coverage. As General Liability respects coverage, Severability of Interest clause is included, per CG00011204 attached. n�Ir-wn�c nvcvcr` V.ANLrCLLA 1 IVN Raitt/McFadden Sandary Sewer Improvements SHOULDANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3C DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 20 Civic Center Plaza REPRESENTATIVES. 10 Days for Non -Payment of Premium Santa Ana CA 92701 AUTMORIZEDREPRESENTATIVE John Garrett AL.UKU 25 (ZOU11UH) © ACORD CORPORATION 1988 on