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<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE �MM /DD /YYW�
<br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBIECT TO ALL THE TERMS, EXCLUSIONS .4ND CONDITIONS OF SUCH POLICIES.
<br />_
<br />12/29/2009
<br />A
<br />PRODUCER
<br />Aon Risk services south, xnc.
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
<br />Atl onto GA Offi ce
<br />AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
<br />LTR
<br />3565 Piedmont Rd NE , Bl gl , #700
<br />CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
<br />POLICY NUMBER
<br />Atlanta GA 30305 USA
<br />COVERAGE AFFORDED BY THE POLICIES BELOW,
<br />LDNI'FS
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
<br />PHONE- 866 283 -7122 FAX- 847 953 -5390
<br />DATE MM/DD/YVYV
<br />C
<br />INsuRED
<br />INSURER A: ACE American insurance company
<br />22667
<br />01/01/2010
<br />sapphire Technologies, LP
<br />e.
<br />INSURER e: xndemni ty insurance co of North America
<br />43575
<br />60 Harvard Mill Square
<br />—
<br />INsuRER C, zuri ch American ins Co
<br />16535
<br />wakefield MA 01880 USA
<br />d
<br />INSURER D:
<br />CLAIMS MADE ® OCCUR
<br />i-
<br />u
<br />'O
<br />Anv one person
<br />INSURER Eo
<br />$ S , 000 , 000
<br />p
<br />!�llAlCO Al�.CC
<br />GTR .l ,'l,'l1lP< f1Pf YP,"T< -1 r111 ffl,l 111 Ylll flG rlf YIIP
<br />r1r11lfV
<br />THE POLICIES OF [NSU RANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
<br />ANY REQUIREMENT, TERM OR CONDITION OF .4NY 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 SUBIECT TO ALL THE TERMS, EXCLUSIONS .4ND CONDITIONS OF SUCH POLICIES.
<br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED
<br />INSR
<br />A
<br />ATTN : LORI SMITH
<br />DATE THEREOF, THE ISSUING INSURER WIL[. ENDEAVOR TO MAD.
<br />_
<br />LTR
<br />INSR
<br />TYPE OF INSURANCE
<br />POLICY NUMBER
<br />POLICY EFFECTIVE
<br />POLICY EXPIRATION
<br />LDNI'FS
<br />-
<br />OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
<br />DATE MM/DD/YVYY
<br />DATE MM/DD/YVYV
<br />C
<br />NERAL LIABILrry
<br />GL0824974300
<br />01/01/2010
<br />01/01/2011
<br />EACH OCCURRENCE
<br />$5,000,000
<br />DAMAGE TO REMED
<br />$ $ , 000 , 000
<br />X CDMMERCIAL GENERAL LIABILITY
<br />CLAIMS MADE ® OCCUR
<br />PREMISES (Ea occurrence)
<br />Anv one person
<br />PERSONAL 8e AD V INNRY
<br />$ S , 000 , 000
<br />GENERAL AGGREGATE
<br />$ 5 , 000 , 000
<br />GEN1 AGGREGATE LIMIT APPLIES PER_
<br />PRODUCTS - COMP /OP AGG
<br />$5,000,000
<br />POLICY � PRO- � LOC
<br />IECT
<br />A
<br />AUTOMOBILE LIAHILFFY
<br />ISAH08581824
<br />10/01/2009
<br />10/01/2010
<br />COMBINED SINGLE LIMIT
<br />X ANY AUTO
<br />(Ea acc:deno)
<br />$l, 000, 000
<br />ALL OWNED AUTOS
<br />APPROVE
<br />S F
<br />RM
<br />BODILY INNRY
<br />SCHEDULED AUTOS
<br />(Per person)
<br />HIRED AUTOS
<br />BODILY INfI lRV
<br />NON OWNED AUTOS
<br />X CA PPT
<br />Jose
<br />Assistant
<br />y
<br />(Per ace :den,)
<br />h Straka
<br />City Attor
<br />PROPERTY DAMAGE
<br />cPer acp�denr>
<br />GARAGE L[AB[LrrV
<br />AUTO ONLY - EA ACCIDENT
<br />ANY AUTO
<br />OTHER THAN EA ACC
<br />AUTO ONLY:
<br />AGG
<br />E.YCESS /UMBRELLA LL4BILFFY
<br />EACH OCCURRENCE
<br />OCCUR � CLAIMS MADE
<br />AGGREGATE
<br />eDEDUCTIBLE
<br />RETENTION
<br />8
<br />A
<br />A
<br />A
<br />wORI:ERS COMPENSATION AND
<br />EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR /PARTNER /EXECUTIVE
<br />OFFICERM�MBER EXCLUDED?
<br />(Mandavpry :n NH)
<br />If es, describe under SPECIAL PROVISIONS below
<br />WLRC
<br />WLRC45703174
<br />sCFC457O31$6
<br />WCUC45703204
<br />W/ 52R $500,000 IOH ONLY)
<br />10/01/2009
<br />10/01/2009
<br />10/01/2009
<br />10/01/2010
<br />10/01/2010
<br />10/01/2010
<br />X
<br />WC STATU-
<br />OTH-
<br />E. L. EACH ACCIDENT
<br />$1,000,000
<br />E.L_D[SEASE -EA EMPLOYEE
<br />$1,000,000
<br />E.L_ DISEASE- POLICY LIMIT
<br />$1, 000, 000
<br />OTHER
<br />DESCRIPTION OF OPE RATIONS /LOCATIONSNEIDCLES/EXCLUSIONS ADDED HY ENDORSEMENT /SPECIAL PROVISIONS
<br />THE CITY OF SANTA ANA, 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND
<br />REPRESENTATIVES ARE NAMED AS ADDITIONAL INSUREDS WITH REGARDS TO LIABILITY AND DEFENSE OF SUITS ARISING FROM THE
<br />OPERATIONS AND U5E5 PERFORMED BY OR ON BEHALF OF THE NAMED INSURED PER ATTACHED CG2010 FORM.
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<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />CITY OF SANTA ANA
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />ATTN : LORI SMITH
<br />DATE THEREOF, THE ISSUING INSURER WIL[. ENDEAVOR TO MAD.
<br />_
<br />1439 5 BROADWAY
<br />3U DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
<br />-
<br />.
<br />SANTA ANA CA 92707 USA
<br />BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATSON OR LIABILITY
<br />-
<br />OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
<br />AUTHORIZED REPRESENTATIVE � O
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<br />The ACORD name and logo are registered marlu of
<br />
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