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ACORD CER <br />rm TIFICATE OF LIABILIT <br />WIA.AnINSURANCE SERVICES/PHS <br />251467 P: (866)467-8730 F: (877)905-0457 <br />PO BOX 33015 <br />SAN ANTONIO TX 78265 <br />INSURED <br />Y INSURANCE DATE <br />I03-26-2009 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <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 />INSURERS AFFORDING COVERAGE <br />`/~~ INSURER A: Hart f ord Casual t Ins Co <br />~~ ~ ~ / ' ~~ INSURER B: <br />O'REILLY & ASSOCIATES INSURER C: <br />75 3 0 SUNNYWOOD LN . INSURER D: <br />LOS ANGELES CA 9 0 04 6 INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED RFI nw HwF aFFni iccii~r, rn T~~ i.~~-,,,,~,......~.. . __. ._ __ <br />rarer tit[2uIHtMtNT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATEIMAY BE SSUED ORDING <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED <br />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 />INSR <br />LTR TYPE OF INSURANCE I POLICY NUMBER DATE MMFDD/YYE ATE (MM/DD/YYN LIMITS <br /> GE NERAL LIABILITY <br /> <br />A <br />COMMERCIAL GENERAL LIAB <br />7 2 SBA A EACH OCCURRENCE $1 , 0 0 0, O O O <br /> ILITY E4 8 6 6 0 6/ 0 5/ 0 9 0 6/ 0 5/ 10 FI <br /> <br />CLAIMS MADE U RE DAMAGE (Any one fire) S3 O O, 0 0 0 <br /> OCCUR <br /> <br />X <br />General Liab MED EXP (Any one person) 51 O , O O O <br /> PERSONAL & ADV INJURY S1, O O O, O O O <br /> <br />GEN'L AGGREGATE LIMIT APPLIES GENERAL AGGREGATE $2 , 0 0 0, O O O <br /> PER: <br />POLICY j <br />X <br />PRODUCTS -COMP/OP AGG <br />S2 , O O O , O O O <br /> LOC <br />ECT <br /> AU TOMOBILE LIABILITY <br />A ANY AUTO 72 .SBA AE4 8 6 6 0 6/ 0 5/ COMBINED SINGLE LIMIT S 1 <br />0 0 0 <br />O O O <br /> <br />ALL OWNED AUTOS 0 9 0 6/ 0 5/ 10 (Ea accident) , <br />, <br /> <br /> SCHEDULED AUTOS BODILY INJURY $ <br /> <br />X <br />HIRED AUTOS IPer person) <br /> <br /> <br />X <br />NON-OWNED AUTOS """ ERR <br />~ <br />BODILY INJURY <br />S <br /> ~O IPer accident) <br /> S <br />O PROPERTY DAMA <br /> , GE <br />(Per accident) S <br /> GARAGE LIABILITY <br />ANY AUTO ~41 <br />Y <br />AUTO ONLY - EA ACCIDENT <br />S <br /> QUO <br />r- `, <br />~~O¢ <br />O ~e7 EA ACC <br />R S <br /> - <br />r <br />~ ~ AUTO <br />ONLYN <br /> <br />EXCESS LIABILITY AGG S <br /> ~G <br />7 ~\ <br /> <br />OCCUR U CLAIMS MADE r <br />~ EACH OCCURRENCE S <br /> PSS~S~ j ~ /~ <br />4 AGGREGATE <br />S <br /> <br /> DEDUCTIBLE <br />S <br /> <br /> RETENTION $ <br />5 <br /> <br />S <br />WORKERS COMPENSATION AND WC STATU- OTH- <br />EMPLOYERS' LIABILITY TORY LIMITS ER <br />E.L. EACH ACCIDENT $ <br />E.L. DISEASE - EA EMPLOYEE S <br />OTHER E.L. DISEASE -POLICY LIMIT S <br />DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />City of Santa Ana, its officers, employees, agents, volunteers and <br />representatives are included as additional insured with <br />respects to the <br />liability coverage indicated under policy number 72SBAAE4866 for th <br />ose <br />operations usual to the insured. <br />CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION <br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />Santa Ana W/O/R/K Center EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> <br />ATTN: Lydia Morgan 30 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE <br />HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPO <br /> <br />10 0 0 E . Santa Ana Blvd . Suite 2 O O SE NO <br />OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />Santa Ana, CA 92701 REPRESENTATIVES. <br /> AUTHORI D RE ENTATIVE ~~~~ <br />/ <br />ACf1R11 9C c r~ro~r <br />® ACORD CORPORATION 1988 <br />