|
,?coR°® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YWY)
<br />?? ? 5/26/2010
<br />PRODUCER (618) 598-8900 FAX: (818) 598-8910 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Venbrook 2nsurance Services, CA Lic OD80832 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />6320 Cano a Avenue HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />g ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />12tH Floor '' '
<br />Woodland Hi11s CA 91367 INSURERS AFFORDING COVERAGE r NAIC #
<br />INSURED ?"???? ?'?1 /\ INSURER A Hart£o rd F1re Insurance CO 19682
<br />`lJ __. _- -__- _-__ __. -_.
<br />Overland Pacific S Cutler 2nc. ,??? -,OZ INSURER B The Hart£Ord zsaza
<br />3750 Schau£e1e Ave. Suite 150' ? wsu RERC Westchester Fire Insurance 21121
<br />l>-2x?? -o`-l?{ II _ ___ _ - _ __ 1
<br />- - - ---
<br />INSURER D: I
<br />Long Beach CA 90809 INSURER E? ? T
<br />cnvconr_vc
<br />THE POLICIES OF INSURANCE LISTED BELOW-HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS .CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDIT IONS OF SUCH
<br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR ADDL. T _ .__... _-_. -_ -_- _- ? - -.
<br />POLICY NUMBER POLICY EFFECTIVE '?, POLICY EXPIRATION _ _..
<br />LIMITS
<br />G E_NERAL LIABILITY ?'. EACH OCCURRENCE $ 1 ,000 000
<br />
<br />X COMMERCIAL GENERAL LIABILITY i,
<br />_._ -.__ _
<br />-DAMAGE TO RENTED
<br />_P REMIS ES jEa occurrence) _
<br />
<br />I $ _
<br />
<br />90? 000
<br />??
<br />A X '. CLAIMS MADE L^ Iii OCCUR 72 UUNTR7859 ? 6/1/2010 6/1/2011
<br />_._ __ - ? _
<br />MED EXP (Any one parson)
<br />I_. - - _ -
<br />`$
<br />__. .
<br />_
<br />10, 000
<br />-- _-
<br />X ? $10 , 000 BS 6PD Ded. '',, i PERSONAL S ADV INJURY $ ? 000 ?O.O O.
<br />Par Claim ? GENERAL AGGREGATE $ 2,000,000
<br />GEN'L AGGREGATE LIMIT AP P_L IES PER' PRODUCTS -COMP/OP AGG $ 2 , OOO? 000
<br />POLICY X PRO ? ? LOC
<br /> AUT
<br />- -. OMOBILE LIABILITY ?. COMBINED SINGLE LIMIT I $
<br />
<br />X
<br />ANY AUTO '. ',
<br />(Ea accitlen[) 1 , 000 , 000
<br />A ALL OWNED AUTOS 72VVNTR7S59 6?1?2010 6?1?2011 BODILY INJURY
<br /> X SCHEDULED AUTOS I, (Per person) $
<br />
<br />
<br />X __ _ _._
<br />-- -___._.-
<br /> _ _
<br />
<br />X l
<br />HIRED AUTOS ?`l *J
<br />ll 1 ?
<br />NON-OWNED AUTOS
<br />APPROV ? AS
<br />
<br />K BODILY INJURY $
<br />
<br />I
<br />(Per accident)
<br /> x -
<br />com Dea sl o00 ---
<br />p
<br />? / `-- ---- _. _
<br />I, PROPERTY DAMAGE $ _
<br /> X Co11 Dad $1,000 I (Per accident)
<br /> GARAGE LIABILITY
<br />
<br />-
<br />,? 31LL9- '
<br />Silt Sheady
<br />AUTO O_ NLY EA ACCIDENT $
<br />-
<br /> ? ANY AUTO ?
<br />?SS1St8II
<br />Ly ALIOrriC
<br />OTHER THAN E_A_ ACC $
<br /> '
<br />H AUTO ONLY AGG $
<br /> ESS/UMBRELLA LIABILITY
<br />EXC EACH OCCURRENCE S 2,0001
<br />000
<br /> !XOCCUR CLAIMS MADE I LAGGREGATE _-- $ -
<br />,2,.0001-0.00
<br />
<br />B I DEDUCTIBLE 72RHVTR7 B49 6?1?2010 '. 6/1/2011 ? $
<br /> I RETENTION $ $
<br />
<br />B WORKERS COMPENSATION it X WC STATU OTH
<br /> Y / N
<br />AND EMPLOYERS' LIABILITY _- _ TORY.LIMITS _ ER -__ _. __-. --- _ _
<br /> ?
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE 'I ? ?
<br />' _EL EACH ACCIDENT
<br />-- $ 11 000 , 000
<br /> OFFICER/MEMBER EXCLUDED?
<br />(Mantla[ory in NH) ?
<br />It yes
<br />describe under
<br />72WETQ 9133 I
<br />6?1?2010 6?1 2011 -
<br />- 1
<br />[_EL DISEASE EA EMPLOYEE
<br />-' --. ---
<br />_$ -
<br />1 X000 , 000
<br /> ,
<br />SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT I $ 1 000 000
<br />C OTHER professional Liab. I G24412763 003 '?, 6/1/2010 16/1/2011
<br />? Ea Claim $2,000,000
<br /> Claims Made '?
<br />Aggregate
<br />$2 , 000 , 000
<br /> $ 50 000
<br />DESCRIPTION OF OPERATONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS
<br />The City o£ Santa Ana, its officers, agents, employees, consultants, spacial counse l 6 representatives included as
<br />additional insured par attached endorsement #CG20260704 where required by contract. Subject to policy terms,
<br />conditions, and exclusions.
<br />*10 DAY NOT2CE OF CANCELLATION FOR NON-PAYMENT OF PREM2LR1
<br />GERTI FIGATE HOLDER CANCELLATION
<br />SHOULD ANY OF THEAB0VE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />City O£ Santa Ana DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
<br />Public Works Agency , M-3 6 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
<br />Attn: Sheri Barkley
<br />P. O . BOX 1988 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
<br />Santa Ana, CA 92702 REPRESENTATIVES.
<br />AUTHORIZED REPRESENTATIVE
<br />Sharon Jones /SHAJON i-J ?--?--
<br />ACORD 25 (2009/01) ©'1988-2009 ACORD CORPORATION. All rights reserved.
<br />INS025 (zoosD?) The ACQRD name and logo are registered marks of ACORD ,
|