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<br />ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID PC I DATf(IlMlOllIYYYYl <br />GRAIN-l 10/02/08 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Chapman ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />License #0522024 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P. o. Box 5455 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Pasadena CA 91117-0455 I NAIC# <br />Phone: 626-405-8031 Fax: 626-405-0585 INSURERS AFFORDING COVERAGE <br />~ED- - <br /> INSURER"- ........"n..' 1m...,.".. ""utl._ -===t== <br /> INSURERS: <br /> The Grain Project INSUflERC <br /> P.O. Box 572 I INSURER!); I <br /> Santa Ana CA 92702 I <br /> IN5I.JRERE <br /> <br />. <br /> <br />COVERAGES <br /> <br />TilE POL\CIES OF INSURANCE LLSTEIl SEL-OW HAVE BEEN ISSUEDTOTHElNSUREDNAMEDAEOVEF ORTI-lEPOLlCVPERlOOI~ICATEONOTWITll5T.or.lOlNG <br />N<:fREOUIREMENT,TERIo.IORCO>DITIONOF/<JolVCONTAACTOROTHERDOCUMENTWITKRESPECTTOWH'CHTHISCERTlfICATEMAVaEISSUEOOR <br />MAVPERTNN,TKE'NBURANCf-AFFOROEOBVTffEPC\.ICIESOESCR'BIDffI:'-RElNISSUBJl;CTTOAL.LTHETERMS EXCLUSIONS MIl CCHlITIONSOF SlJCH <br />I'OlJCIES,AGGREGAIT-LlMITSSHOWNMM>lAVEIlEENREOUCEOBYPAIOCLAIIolS <br /> <br />POLlCYEllPlRATION <br />OATEfIIIM/DDm'l <br /> <br />I!lSR 'l- <br />LTR SAD <br /> <br />pOLICY NUM&I:R <br /> <br />POLICYEFfECTIVE <br />ll...nMMIllDIYY <br /> <br />TYPE OF INllURAMCE <br /> <br />EACH OCCURRENCE <br />OAMAGETO REHTED <br />PREMISES(E,~",,"I <br /> <br />GENERA.LLIABl\JTY <br /> <br />05/16/0B <br /> <br />05/16/09 <br /> <br /> <br />200B21035NPO <br /> <br />MEDEXI'(Aoyonop<<ooo) <br /> <br />A I X <br />CLAIMSMAOE <br /> <br />PERSOH.o.L& MJV INJURY <br /> <br />GENERALAGGIlEGATE <br /> <br />PRODUCTS.COI,IPiOPAGG <br /> <br />GErfl. AGGRH;ATE LNIT APPLIES PER <br /> <br /> <br />AUTO ONLY-EA ACCIDEHT <br /> <br /> <br />CoME\INEDSIHGLEL.IMlT <br />IEooo:.i<lon11 <br /> <br />I ~,o.::'::.~ <br /> <br />~ AL.L.OWNEDAUToS <br /> <br />I ~e'"ro",ro'cm' <br />,HIREDAUTOS <br />NONDWNWAUTUS <br /> <br />BOOlL.YIHJURY <br />1p"'fIo'lIO'1l <br /> <br />800IL.YINJURY <br />Ipora<ci<l.n') <br /> <br /> <br />PRoPERTYOMlIIGE <br />(f'"accod<>ntl <br /> <br /> <br />NolYAUTO <br /> <br />OTHER THAN <br />AIJTOOHLY <br /> <br /> <br />EXCU$lUMBRaLALlABlUlY <br />~"''"' r:::J'~.'.^" <br /> <br />tDEDUCTIBLE <br /> <br />, <br /> <br />/ <br /> <br /> <br />LIIIITS <br /> <br />$ 1,000,000 <br />$ 100,000 <br />s 10,000 <br />s 1,000,000 <br />s 1,000,000 <br />$ 1,000,000 <br /> <br />--f,-- <br />===-- <br /> <br />EJlACC <br /> <br />,co <br /> <br />-I: <br /> <br />WORKElUICOIIIlPENSATlONANll <br />IEMPLOYERS'LI/l.BLITY <br />ANYPROPRIETORIPARTNERIEXECUTI\IE <br />OFFICER.'O.IEMBEREXCLlJDED? <br />11y"".""'''''Oeuno.r <br />SPECIAL. PR,uVISIONS b.low <br /> <br />lOTI'- <br />" - <br />ELEACHACCIDENT~ <br />EL.DISEASEE/l.EMPLOY~~_ <br />E,L..DISEA~_POUcYLlMIT $ <br /> <br /> CITY SAT SNOULll/l.NYOFTlIE/l.BOvEDEBCRlBEDPOUCIESBECANCELLEDBEFORETlIEElCPIlUTlO" <br /> DATETNEllEOF.TlIEIS3UINGIHSlJRERIMLLENDEAVORTO.....IL 30 O/l.n_rnN <br /> ItOTlCETOTHEnRTlFICATEHa.OERM,O./IlEDTOTHELEFT.BUTFAlLURETODOSOSHAll <br />The City of Santa Ana IlI.P03ENOOIIUG/l.noHOIILlABLlTYOF#lYKINOUPONTHEINlIURER.m1AGENTSOR <br />20 Civic Center Plaza REPRESENTATIVES. <br />Santa Ana, CA 92702 ~l.A' TUIVE <br /> CI -v 7 <br /> <br />RETENTION <br /> <br />I~" <br /> <br />OESCRlPTlON Of OPEAATlOfIS I LOCATlO"SIVENICLESIEXCLVSIONSADDEll BYENDORSE/IIENTISI'ECl/l.L PROVISIO !IS <br /> <br />The City of Santa Ana, their officers, employees, agents and volunteers are <br />named additional insured with respect to the operations of the named insured <br />per the attached CG 2026 endorsement. Such insurance is primary and <br />non-contributory 10 days notice of cancellation for non-payment of premium. <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />ACORD 25 (2001108) <br /> <br />@ACORD CORPORATION 1988 <br />