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,4co CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) <br />~-~ 04/13/2010 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY <br />!i Aon Risk Services Northeast, Inc. <br />New York NY Office AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER TffiS <br />199 Water Street CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE <br />New York NY 100 38-3 5 51 USA COVERAGE AFFORDED BY THE POLICIES BELOW. <br />PHONE- 866 283-7122 FAX- 847 953-5390 INSURERS AFFORDING COVERAGE NAICi/ <br />INSURED INSURERA: MItSUI Sumitomo insurance Co of America 20362 <br />NEC Corporation of America w <br />INSURER B: Mitsui Sumitomo Insurance USA Inc. 22551 <br />6555 N State Highway 161 <br />Irving Tx 75039-2402 USA <br />INSURER C: ~ <br />d <br />b <br /> .. <br />v o ~ <br />o ~ o INSURER D: <br />_ <br />~ _ 3 <br /> INSURER E: ~ <br />COVERA(:F.S SIR aoolies Der terms and conditions of rhP nnlirv '~ <br />THE POLICIES OF INSURANCE LLSTID BELOW HAVE BEIN ISSUED TO THE INSURID NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIItEMENT, TERM OR CONDTIION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY <br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THIi TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />AGGREGATE LIIv11TS SHOWN MAY HAVE BEEN RIDUCID BY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED <br />INSR D' <br />LTR INS TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPDtATION LIMITS <br /> ATE M/DD DAT MM/DD <br />A NERALLL4BH.FrY GL2000022 <br />G <br />l <br />i <br />bili 04/01/2010 04/01/2011 EACH OCCURRENCE $1,000,000 <br /> x enera <br />L <br />a <br />ty <br /> COMMF,RCIA1, GENF.R AL i.IABILITY DAMAGE TO RENTED $300, 000 <br /> PREMISES (Ea occurrence) <br /> CLAIMS MADE ~ OCCUR v one person <br /> PERSONAL & ADV INJURY $1, 000, 000 <br /> <br /> GENERAL AGGREGATE $2,000,000 <br /> <br /> GEN1. AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS -COMP/OP AGG <br />$1, 000, 000 <br /> ^X POLICY ^ PRO- ^ <br />LOC <br /> JECT <br />B AuTOMOS[LELIABIUTY BVR8000052 04/01/2010 04/01/2011 <br /> <br />x ANY AUTO All StdteS COMBINED SINGLE LIMIT <br />(Ea accident) <br />$1, 000 , 000 <br />A BvR8405080 04/01/2010 04/01/2011 <br /> ALL OWNED AUTOS MdS SdChll5ett5 <br />BODILY INJURY <br />B SCHEDULED AUTOS BVR$302206 04 <br />/01/2010 04/01/2011 (per person) <br /> PA <br /> x HIRED AUTOS <br /> <br />x <br />NON OWNED AUTOS APPROVE AS TO ORM (Pe°accident~Y <br /> SELF INSURED FOR PROPERTY DAMAGE <br /> PHYSICAL DAMAGE (Per accident) <br /> GARAGE LIABILITY I,a.UI Stl Sheedy AUTO ONLY - EA ACCIDENT <br /> <br /> ANY AUTO p- <br />SSlSta Clty AitDI y <br /> , OTHER THAN EA ACC <br /> AUTO ONLY <br /> AGG <br />A EXCESS /UMBRELLA LIABH,ITY UM65000098 <br />U <br />b <br />ll <br />C 04/01/2010 4 1 1 EACH OCCURRENCE , <br /> <br />OCCUR ^ CLAIMS MADE m <br />re <br />a <br />overage <br />AGGREGATE <br />$5,000,000 <br /> <br /> DEDUCTIBLE <br /> ® <br />510 <br />000 <br /> . <br />RETEN~rIDN <br />A WCP 1 5 4 x WC STATU- OTH- <br /> WORKERS COMPENSATION AND <br />' Tt <br /> EMPLOYERS <br />LL4BH.DY E.L. EACH ACCIDENT $1, 000 , 000 <br /> ANY PROPRIETOR /PARTNER / EXECUTNE <br />OFFICER/MEMEER EXCLUDED? <br />(Mandatory in NH) <br />E.L. DISEASE-EA EMPLOYEE <br />$1, 000 , 000 <br /> E.L. DISEASE-POLICY LIMIT $1, 000 , 000 <br /> If , descnbe under SPECIAL PROVISIONS below <br />A GL2000022 04/01/2010 4 1 1 Per Claim/Agg $2,000,000 <br /> OTHER errors & omissions <br />Deductible $100,000 <br /> E8A-Proft.i abpri <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />THE CITY OF SANTA ANA ARE NAMED INSURED AS PER ATTACHED FORM. <br />n <br />n <br />N <br />M <br />O <br />O <br />f\ <br />z <br />d <br />U <br /> <br />CERTIFICATE HOLDER CANCELLATION <br />CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />ATTN : CARL MAREK DATE THEREOF, THE ISSUING INSURER WILL B~hVAR~9 MAIL ~ <br />20 CIVIC CENTER PLAZA 30 DAYS WR11-I EN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />P.o.aox 1988 - <br />M-77 ' <br />SANTA ANA CA 92701 USA AUTHORIZEDREPRESENTATNE ~ ~,..,E~~.~..~:w~/f/.~t.~t.~~ <br />ACORD 25 (2009/01) ®1988-2009 ACORD CORPORATION. All rights reserved= <br />The ACORD name and logo are registered marks of ACORD ' <br />