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<br />ACORD~ <br /> <br />1"1./ <br /> <br />L.UOb' -()?r5 <br /> <br />'/ <br /> <br />PRODUCER <br />MARSH RISK & INSURANCE SERVICES <br />1 CALIFORNIA STREET <br />CALIFORNIA LICENSE NO. 0437153 <br />SAN FRANCISCO, CA 94111 <br />AlIn: Audrey Se9alld (415)743-8632 <br />19025.BOND-MM-08_09 <br /> <br />CERTIFICATE OF LIABILITY INSURANCE <br /> <br />r,^,t.\f.l:,";n'n" <br /> <br />1 O'G:l120011 <br /> <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATlOr <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OF <br />ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. <br /> <br />BOND LOGISTIX LLC <br />FUND SERVICES ADVISORS, INC. <br />777 SOUTH FIGUEROA STREET, SUITE 3200 <br />LOS ANGELES, CA 90017 <br /> <br />I <br />INSURERS AFFORDING COVERAGE _ _: NAlC!' <br />'NSURER A: Twin City Fire Insurance C!' ~9459 <br />INSURERS: Hartford Underwrilers Insurance Company ,30104 <br /> <br />II'NNSSUURREERR.O C',: -~-=-~~-'_- ~ ~ I <br />--- ----L <br />I'N5URERi <br /> <br />NSURED <br /> <br />:OVERAGES' '- - _'_ __ __ _ __ _ -,- <br />-THE POLlC'IES OFINSURANCE LISTED BELOW' 'HAVE BEEN ISSUED TO THE INSURED NAMED ABoVE FOR THE POliCY PERIODIND/CA TED, <br />NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOcUMENT WITH RESPECT TO WHICH THIS CERTIFICATE <br />MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND <br />CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />~::~~ TYPE~~~ ,- POllCVN~"'~-~A~~:~~~~~="- - LIMITS <br />;GEN R ... EA~C RENe ._L <br />- rDAIAAGE TO RENTED <br />L I CO~lMERCIAl GENERAL LIABILITY PREMISESlEo """',,",co, $ _ _ <br />~ . ' ClAIMS MADE r --' OCCUR M~ '^'" ""0 ..""n) S _ <br />' -- . - - - - PERSONAl & AOV INJURY $ <br />L.l_ - - - GENE_AGGReGATE 1$ --- <br />~ENERALAGGREGAr~,\'~IT APPLIES PER ~ROOUCTS'COMPIOP~ <br />i POLlCY JECT I LOC <br />I AUTOMOBILE UABlUTY <br />n ANY AUTO <br />BALL OWNED AUTOS <br />. SCHEDULED AUTOS <br />HIRED AUTOS <br /> <br />NON-OWNEO AUTOS <br /> <br />COMBINED SINGLE LIMIT $ <br />(E4:l ncetdenl) <br />r OOOlLYINJURY ~ <br />(Perpen;on) <br /> <br />GARAGE UAEaUTY <br />'---; <br />J ANY AUTO <br />EXCESSIUMBREUA UABlUTY <br />""-'-'-'1 OCCUR ~ I CLAIMS MADE <br />' L_ <br /> <br />l DEDUCTIBLE <br /> <br />BOOll Y INJURY <br />(Per accident) <br />----..--. <br />PROPERTY DAMAGE <br />(Petaccidcnl) <br /> <br />$ <br /> <br />$ <br /> <br />RETENTION $ <br />WORKERS COMPENSATlON AND <br />EMPLOYERS' UABlUTY <br />ANY PROPRIETORIPARTNERiEXECUTIVE <br />OFFICEAA.EMBER EXCLUDED? <br />, <br />, If Vl!'S, de5Cribe under <br />i SPECIAL PROVISIONS below <br />OTHER <br /> <br />AGG <br />~. .._ H OCCU~r:tENCE <br />AGGREGATE <br />~~_.- - <br />.~-- <br /> <br />AUTO ONLY -EA ACCIDENT i$ <br />EAACC S- <br />aTHER THAN <br />AUTO ONLY; S <br /> <br />$ <br />$ <br />$ <br />$ <br /> <br />57 WE TU9541 (ADS) <br />57 WE TU9541 (TX) <br /> <br />10101108 <br />10101/08 <br /> <br />10/01/09 <br />10101109 <br /> <br />x <br /> <br /> <br />OTH- <br /> <br />.L EACH ACCIDENT $ <br />.L DISEASE. EA EMPLOY $ <br />-- <br />.L DlSEASE . POLICY UMlT $ <br /> <br />""1;000,001 <br />-.'- <br />1.000,001 <br />1,000,00( <br /> <br />SCRIPTION OF OPERATlONSlLDCATlONSNEHtcLES/EXCWSIONS ADOED BY ENOORSEMENT/SPE:CIAl. PROVISIONS <br />idence of Workers' Compensation coverage. <br /> <br />APPRO ED AS TO FORM <br /> <br />"- <br />Laura Stitt Sheedy <br />Assistant City Attorney <br /> <br />:RTIFICATE HOLDER <br /> <br />SEA-001249344-o2 <br /> <br />CANCElLATION <br /> <br />City of Sonia Ana ./..; ./ <br />Altn: Bich Ta X 5 't-. .,. <br />20 Civic Center Plaza M-17 <br />Santa Ana, CA 92701 <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEUED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER wru ENDEAVOR TO MAlL <br />~ DAVS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMfO TO THE LEFT, <br />BUT FAILURE TO DO SO SHAlL lro1POSE NO OBLIGATION OR: LIABILITY OF ANY KIND <br />UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, <br />A~T~~i~'1~~~T~ervsetlVices .~ <br />Gene WiJlinms <br /> <br />ORD 25 (2001/08) <br /> <br />,~ ^f"ADn "'1"'\n:no""lM~T'''''''' ....."" <br />