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<br />ACORD. CERTIFICATE OF LIABILITY INSURANCE OP IDDV I OAn(MMlDOiVYYV) <br />LIEBE-l 05/13/09 <br />PRODuCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Narver Associates, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />641 W. Las Tunas Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />PO Box 1509 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />San Gabriel CA 91776 <br />Phone: 626-943-2200 Fax: 626-299-1010 INSURERS AFFORDING COVERAGE NAIC# <br />IOISURSD INSURER. V.H.y........'.....n.._~y <br /> 1000URER ~. Co"u.n_.to! "".....uy C<ooo>""y <br /> Liebert Cassidy Whitmore INllUREAC: Westport Insurance Company <br /> Danielle M. MQlette <br /> 6033 W. Cen tury 81 vd. , Ste.SOD lNSURERO" <br /> Loa Angeles, CA 90045 <br /> INSURERE <br /> <br />COVERAGES <br /> <br />THEPOlIClESOFIR8VR,f,NCEUSTED9ELOWH"VEBE'EN'SSUEDTOTItEIHSUREDN.o.liIED"SOIIE FORTHE POUC'l' PERIOD INOICIlT w. NOTWITHST"WOIND <br />ANYREOOIREIoIENT.TERIoIORCONDITIl.>NOF...NYCONTRACTOROTHERPOCUW:NT WlTHRElIPECTTOWHICHTHI8CERTIFlCIITEW\Y8EI8IUEDO/l <br />.....VPERTAIH.THEIOI8URAMCEMFORDE08VTHEPOllCJUOESCRlIIEDHEOIElNIS8UIlJECTTO"'LLTHETERMS.EXClU'IQN'~NDCONOlTIONSOfsUCH <br />POUClES_AaaREGATElNITS8NOWNM"YHIlVEBEE"REDUCECBYP~ICCLAlM8 <br /> <br />INSR DD'l <br />LTII SRD <br /> <br />TYl'ED~lf\I5UIlANCE <br /> <br />I'OUCYNUIlI~ <br /> <br />I'OUCYEFI'ECTIYE <br />I>>.TE(MMIDl>IY'1 <br /> <br />I'OUCYEXPlllAnON <br />OIITE(MIM>O/YT) <br /> <br />UMITS <br /> <br />A <br /> <br />x <br /> <br />GENEIlALU....,UTY <br />l- <br />X COIdMERC"-LCENER"lUABILlTY <br />I ct.A1~ MMlE C!.J OCCUR <br /> <br />2099768453 <br /> <br />12/14/08 <br /> <br />12/14/09 <br /> <br />E"CHOCCURIIENCE <br />OMlMlETORENTEC <br />PIIEMI8SS(Eoo""""n,.) <br /> <br />, $2,000,000 <br />1$300,000 <br />1$10,000 <br />, $2,000,000 <br />, $4,000,000 <br />, $4,000,000 <br /> <br />MEDEXPV...,..........n) <br /> <br />~ <br /> <br />P'ER.OO"L."DVINJUIIY <br /> <br />GENEIl.O.lMOREC"TE <br /> <br />~cEN'L"",OREGATEUMIT~P""'ESPH'n <br />r-l PRO- <br />X POlICY ~__lJECT WC <br /> <br />PROOUCTE_COMPH)/>I<GC <br /> <br />x <br /> <br />~TOMOBIUL"""lITY <br />I<N'f,o,uTO <br />- <br />~lLOWNEOl<UTO' <br />- <br />- <br />X HIIIEC~UTOS <br />- <br />X NON.cmNEOAUTOS <br />~ <br />- <br /> <br />COMEINE08INOLELlMIT <br />(Eo ""''''''''l <br /> <br />, $1,000,000 <br /> <br />8CHEDULEO"uTos <br /> <br />BOOIlYI.....URY <br />!P.,p....'" <br /> <br />A <br />A <br /> <br />2099768453 <br />2099768453 <br /> <br />12/14/08 <br />12/14/08 <br /> <br />12/14109 <br />12/14/09 <br /> <br />BOOILYINJUIIY <br />lPo,o"""Onl) <br /> <br />PRCPERTYDAMACE <br />!P.,oooido"'l <br /> <br />~F:7::~n <br /> <br />I<UTOONLV-E,O,.o,cCIOENT <br /> <br />OTHERTH~N <br />~UTOONLY <br /> <br />E"~cc <br /> <br />'00 <br /> <br />B <br /> <br />EJ(CEBS/uMBREU-IllIAllIUTY <br />~OCCUR o CLANs "'''DE <br /> <br />IIOSO\JCTIBLE <br />~RETENTION <br /> <br />E~CH OCCURRENCE <br /> <br />$ $2,000,000 <br />$ $2,000,000 <br /> <br />2099769408 <br /> <br />12/14/08 <br /> <br />12/14/09 <br /> <br />""'GREG.OTE <br /> <br />,10,000 I <br /> <br />\YQIIKElUCOMPEN$AnON~ND <br />Er.lPlDYEIIS'UABIUTY <br />"NYPROPRIETOIUP"RTNEFUEXECUnllE <br />OmCERlME"'BERE!\CLUDEO? <br /> <br />IT:;:'~~:I~~. I 10::, <br /> <br />E_l,E"CH"CcrDENT <br /> <br />or,...d,,<rlbou_, <br />.PEClAl PROVI.,ONS b...... <br /> <br />E.L.OISE,O,SE.E"E"'PLOVEE <br /> <br />E,LDI8t"1<8E-POLICYU"'1T <br /> <br />0_' <br /> <br />c <br /> <br />Professional Liab. <br /> <br />WLL301009307100 <br /> <br />12/10/08 <br /> <br />~a CI?m /"7 $2,000,000 <br />A\q~ate/ / $2,000,000 <br />~PR~VEy',h">-/F <br />'j X< <br />Jose Sando't.ol <br />f Jenior Assistant City Attorney <br />CANCELLATIONV <br /> <br />12/10/09 <br /> <br />CE8CIIIPTlONOfOPEAAnONSILOc"nONSIVEHICLU'UCLUSIONS"OlIECBYENOOllIEMENTISPEC,,,lPRQYISIONS <br /> <br />*10 day notice of cancellation in the event of a non-payment of premium. <br />Certificate holder is named as an additional insured in regardm to the <br /> <br />general liability policy. <br /> <br />CERTIFICATE HOLDER <br /> <br />CITYSAA <br /> <br />SHOULD.~YQFTHE".DY~IIliSC""BEO~QlICIEliaEC.~CEllEOBEF<I"'''THEEXP'R.T1O'' <br /> <br />llATETHEREllF, THEIESUI~\;IINSURERWlLLENDEAYDRTQ M"IL <br /> <br />30' <br /> <br />Q.YSWRfTTEN <br /> <br />City of Santa Ana <br />20 Civic Center Pla~a <br />P.O, Box 1988 <br />Santa Ana CA 92702 <br /> <br />NQTlClITQTHECERTlflC.TEHOLOEM....".EDTOTHEUlFT,8UTF.,LURETQOOSOSH.LJ,. <br /> <br />'MfOUNQ08uo.nCNORUMIUTYOF.NYKINDUP"NTHE'NSUIlU.IT1I."ENTSCR <br /> <br />RE~SENT..nVES. <br /> <br />ACORD 25 (2001/08) <br /> <br /> <br />--d <br /> <br /> <br />@ACORD CORPORATION 1888 <br />