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ACURD.µ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDlYY) 4/20/2009 PRODUCER JONES AND COMPANY INSURANCE AGENCY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 505 S. VILLA REAL ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE SUITE 115 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ANAHEIM HILLS CA 92807 877 566-3 __ ~~_~~ 726 INSURERS AFFORDING COVERAGE _- INSURED - - - -- --- INSURERA Employers Flre Ins Co N 2048 INFOSEND INC. --- - __._ _ ___ __-_ ___ -_-_ , INSURER B: United Financial Casualty Go IC# 770 - -- -------- ~ 1041 S. PLACENTIA AVE A-2009-037 ~ ---- -- ------------------ -- INSURERC: AXIS Surplus Insurance Comp~fny N C#26620 ~ _. _ " INSURER D: , ~"''~ FULLERT N CA 92831 I rnvenwn~~ wsuRERE: -_ _---- -------_-)------~---------_____-- THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING . ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFLCxATE ~' BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS;7iND CONDITIONS OF SUCH , POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS . INSR POLICY EFFECTIVE POLICY EXPIRATION ~~ ~ ~~ ~-~ ~ ~_ "" - ~-"-_-_"~ I POLICY NUMBER --"~-----I-------- LTR TYPE OF INSURANCE DATE MMlDDIW DATE MMIDD ~ LIM GENERAL LIABWTY --~ EACH OCCURREN~ 2 OOO OOO r r ~- .COMMERCIAL GENERAL LIABILITY f-- ---- FIRE DAMAGE (Any one fire) $ 300 000 l ~ CLAIMS MADE ~ X I OCCUR , - -- ----- -- _.-.._ A I i ~ MED EXP (Any one person) $ 5 OOO ~ - ~ -- ---- ~ -- r---, -- _._._._ ____ 1 046885 2/24/2009 2/24/2010 ;PERSONALB.ADV INJURY $ 2,000,000 I _".- i j r-- ---~ -- --- --- 'GENERAL AGGREGATE i $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: '-- ( ,_ _ _ `PRODUCTS -COMP/OP AGG i $ 4 OOO OOO PRO- LOC i X POLICY ~ JECT _...-... - .----------~---- ~ ---- ~ .._._ i AUT OMOBILE LIABILITY j F---~ ANY AUTO i I I COMBINED SINGLE LIMIT i' $ 1 OOO,OOO (Ea accident) s -- ALLOWNEDAUTOS I ~ ---------------------------------- B X --- X SCHEDULED AUTOS 06546590-0 ~ 2!1312009 I , 8/13/2009 j --------------- ------_---_ - - ~-~-~~--~ $ X - HIRED AUTOS NON-OWNED AUTOS _ ,_ PPK(~~/~~ AS I'~ I~ A w ; ,. ~ iti'~J BODILY INJURY (Per accident) $ ~ ~ -_-- -_ _--_.-_-- _._ --_--' PROPERTY DAMAGE Per accident ~ $ ` I GARAGE LIABILITY i , ~ -~----1-- : q~~,_, ,-. . i `~4. 1USA }~ ~ ~l c L AUTO ONLY - EA ACCIDENT $ -.__- --- ANY AUTO ~ _ - , , i ~ ; , , ` ~ OTHER THAN _EA ACC $ AUTO ONLY: AGG $ Xc OCCURBILITY f I j CLAI I _ - F - -'----- EACH OCCURRENCE $ 2 OOO,OOO -- - -I ,_ - _ j MS MADE I AGGREGATE ($ 2,000,000 A ~ ~ --- 1046885 ~ 2!24/2009 ~ 2124!2010 j - --- _-- i$-- _____ I X I DEDUCTIBLE 10,000 - -- -. ____. _ --- RETENTION $ j --- ---~--- ---~" ~-- $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY I I I r WC STATU- OTH- TORY LIMITS ER -- -_~_ -. I E.L. EACH ACCIDENT i $ I E.L. DISEASE - EA EMPLOYE ~-----------'---- $ j E.L. DISEASE -POLICY LIMIT $ OTHER ~ EACH ACT 1,000,000 C iPROFESSIONAL LIABILITY ECN9970801 12/ ~ j 1/2008 12/1/2009 TOTAL LIMIT 1,000,000 ~ RETENTION 5,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONSADDED BY ENDORSEMENTISPECIAL PROVISIONS ADDITIONAL INSURED: CITY OF SANTA ANA, PER FORM CG2010 07104. (attached) ''*10 DAYS NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM. I va. r~ r ~r n.h ~ c nvLUCrt AUDI l eONAL INSURED; INSURER LETTER: CANCELLATION '25 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF SANTA ANA DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN MARELLA VARGAS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 30 SHALL PO BOX 1964 IMPOSE NO OB~IaA~ION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR SANTA ANA CA 92702 `" '~~ '~ ACORD 25-S (7/97) ©ACORD CORPORATION 1988 LM: LPW v1.9.8 on 4/20109 - 9:51 by UserName LP: LPW v1.9.8 on 4/20/09 - 9:52 by rName PF v1.0.1