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ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID JS DnrE (MINT DDrcryyI <br />PRODUCER <br />LINAMIl 03 31 09 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ISII - Robert Bell Brokers <br />5256 S. Mission Rd. Suite 1006 <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 />Bonsall CA 92003 <br />Phone: 800- 426 -2634 Pax:760- 631 -5983 <br />INSURERS AFFORDING COVERAGE NAIC# <br />INSURED <br />INSURER A, Zurich North America <br />16535 <br />INSURER B: <br />PAS 36068105 <br />02/28/09 <br />Mike Linares <br />P.O. Box 3913 <br />San Clemente CA 92674 <br />INSURER C: <br />$1,000,000 <br />INSURERD: <br />$10,000 <br />INSURER e <br />$ <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 ISSU BD OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED 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 />D <br />LTR NBR TNT E OF INSURANCE POLICY NUMBER DATE (MWDnYY) DATE MMIDD I LIMITS <br />GENERAL LJABILfTY <br />EACH OCCURRENCE <br />$1,000,_000 <br />A <br />x <br />COMMERCIAL GENERALLIABILITY <br />CLAIMS MADE ❑ OCCUR <br />% Business Owners <br />PAS 36068105 <br />02/28/09 <br />02/28/10 <br />PREMISES Ea occ�- �mnce— <br />$1,000,000 <br />MED EXP (Anyone pereon) <br />$10,000 <br />PERSONAL& ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />52,000,000 <br />GENT AGGREGATE LIMIT APPLIES PER: <br />POLICY n PRO- <br />E ECT 7 LOC <br />PRODUCTS - COMP /OP AGO <br />$2,000,000 <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Eo aecloenQ <br />$ <br />ALL OWNED AMOS <br />SCHEDULEDAUTOS <br />BODILY INJURY <br />(Per penan) <br />S <br />HIREDAUTOS <br />NON.OWNEOAUTOS <br />BODILY INJURY <br />(Per arrJtlanlJ <br />S <br />Q <br />0 <br />PROPERTY DAMAGE <br />(Poraccltlentl <br />$ <br />GARAGE LIABILITY <br />ANY AUTO <br />AUTO ONLY - EA ACCIDENT <br />5 <br />OTHERTHAN EA ACC <br />S <br />AUTO ONLY: AGO <br />5 <br />EXCESSIUMBRELLA UABILT' <br />OCCUR CLAIMS MADE <br />aU <br />P*ssisLa4 <br />L1LL Ei <br />A LLOSD <br />Clly <br />EACH OCCURRENCE <br />5 <br />AGGREGATE <br />$ <br />s <br />DEDUCTIBLE <br />_ <br />5 <br />RETENTION 5 <br />$ <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />I TORV LIMITS Eft <br />E.L. EACH ACCIDENT <br />S <br />ANY PROPRIETOMPARTNEWEXECURVE <br />OFFICEWMEMBER EXCLUDED? <br />If a, 000alho ueEor <br />SPECIAL PROVISIONS below <br />E.L. DISEASE -EA EMPLOYE <br />8 <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />*10 day notice of cancellation for non - payment of premium.* The City of <br />Santa Ana and its elected and appointed boards, officers, agents <br />and employees are additional insured with respect to subject project and <br />contract with the city. This insurance is primary and any insurance <br />maintained by the aditional insured shall be excess. <br />CITYSAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOf <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* GAYS WRITTEN <br />City of Santa Ana NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />714-637-5379 IMPOSE NO OBLIGATION OR LIABILITY OF ANY VINO UPON THE INSURER, ITS AGENTS OR <br />20 Civic Center Plaza REPRESENTATIVES. <br />Santa Ana CA 92701 AUTHCRITEI REPRE5ENTAJJVy3 <br />ACORD 25 (2001108) n AOnRn rnacnaA-nnN goRA <br />