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Client #: 50903
<br />BUCKASO
<br />ACORD,. CERTIFICATE OF LIABILITY INSURANCE
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />/241M/OD/YYYY)
<br />08/24/2010
<br />PRODUCER
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Willis Ins, Srvcs of CA, Inc.
<br />18101 Von Karman Ave
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
<br />Suite 600
<br />POLICY EXPIRATION
<br />DATE MM /DD/YY
<br />LIMITS
<br />Irvine, CA 92612
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSURED
<br />INSURER A: Travelers Property Casualty CO
<br />36161
<br />30131 Town Center Drive, Suite 268 &Associates, Inc.
<br />30131
<br />Laguna Niguel, CA 92677
<br />114SURER B: Continental Casualty Company
<br />20443
<br />INSURER C:
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS MADE � OCCUR
<br />INSURER D
<br />INSURER E:
<br />DAMAGE TO RENTED
<br />PRE
<br />$1,000,000
<br />COVERAGES
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />S R
<br />LTR
<br />kDD'L
<br />NS
<br />TYPE OF INSURANCE
<br />POLICY NUMBER
<br />POLICY EFFECTIVE
<br />DATE JMMIDDIYYI
<br />POLICY EXPIRATION
<br />DATE MM /DD/YY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />680488OL652
<br />09/01/10
<br />09/01/11
<br />EACH OCCURRENCE
<br />$1000000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS MADE � OCCUR
<br />DAMAGE TO RENTED
<br />PRE
<br />$1,000,000
<br />MED EXP (Any one person)
<br />$10,000
<br />PERSONAL & ADV INJURY
<br />$1,000,000
<br />GENERAL AGGREGATE
<br />$2 000 000
<br />GEML AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP /OP AGG
<br />s2,000,000
<br />POLICY PRO-
<br />JECT LOC
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />680488OL652
<br />09/01 /10
<br />09/01/11
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$INCL IN GL
<br />BODILY INJURY
<br />(Per person)
<br />$
<br />ALL OWNED AUTOS
<br />SCHEDULED AUTOS
<br />HIRED AUTOS
<br />NON -OWNED AUTOS
<br />APPROVED AS
<br />j
<br />TO FOR
<br />% ,
<br />X
<br />X
<br />BODILY INJURY
<br />(Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />(Per accident)
<br />$
<br />Laur t[ Sheedy
<br />GARAGE LIABILITY
<br />ASSTS Clty
<br />Attorney
<br />AUTO ONLY - EA ACCIDENT
<br />$
<br />OTHER THAN EA ACC
<br />$
<br />ANY AUTO
<br />$
<br />AUTO ONLY: AGG
<br />A
<br />EXCESS /UMBRELLA LIABILITY
<br />CUP7637Y444
<br />09/01/10
<br />09101/11
<br />EACH OCCURRENCE
<br />s4,000,000
<br />X1 OCCUR EI CLAIMS MADE
<br />AGGREGATE
<br />s4,000,000
<br />$
<br />DEDUCTIBLE
<br />$
<br />X RETENTION $ O
<br />A
<br />WORKERS COMPENSATION AND
<br />UB711 OY58A
<br />09/01/10
<br />09/01/11
<br />X WCRY L TIU- OTH-
<br />EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />E,L, EACH ACCIDENT
<br />$1 000,000
<br />E.L. DISEASE- EA EMPLOYEE
<br />$1,000,000
<br />OFFICER/MEMBER EXCLUDED?
<br />It yes, describe under
<br />SPECIAL PROVISIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$1,000,000
<br />B
<br />OTHER
<br />Professional
<br />AEA113988680
<br />01/02/10
<br />01/02/11
<br />$1,000,000 Per Claim
<br />Liability
<br />$2,000,000 Aggregate
<br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
<br />GENERAL LIABILITY: CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS,
<br />VOLUNTEERS AND REPRESENTATIVES ARE NAMED ADDITIONAL INSURED PER ATTACHED
<br />ENDORSEMENT.
<br />Lz -R;;a 11.1 Le_ua: Lai erlM111
<br />CITY OF SANTA ANA
<br />PUBLIC WORKS DESIGN ENG
<br />ATfN: JUDY ALVARADO
<br />PO BOX 1988
<br />Santa Ana, CA 92702
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_ DAYS WRITTEN
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
<br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
<br />REPRESENTATIVE
<br />ACORD 25 (2001108) 1 of 2 #S467969/M467934 CCL © ACORD CORPORATION 1988
<br />
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