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vE—NIL a as av+i--%a a— va r..1r1%5.#116_1 I a 04/10/ZC09 <br />PRODUCED (714)979-6543 FAX (; `) 549-2943 THIS CERTIFICATE If " SUED AS A MATTER OF INFORMATION <br />Wigmore Insurance Agency, Inc. ONLY AND CONFERS ) RIGHTS UPON THE CERTIFICATE <br />2970 Harbor Blvd. #215 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />License #0811959 <br />Costa Mesa, CA 92626 INSURERS AFFORDING COVERAGE NAIC # <br />INSURED Share Our Sel ves INSURERA: Travelers Property Casualty Co, of America <br />1550 Superior Ave. INSURERS: Travelers Indemnity Co. of Connecticut <br />Costa Mesa, CA 92627 INSURERC: <br />INSURER D: <br />INSURER E: <br />nnv9oencc <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 CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />DD' <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />EACH OCCURRENCE S 1,000,0 <br />GENERAL LIABILITY <br />66083OX485009 <br />01/26/2009 <br />01/26/2010 <br />X COMMERCIAL GENERAL LIABILITY <br />1PCLAIMS MADE FX OCCUR <br />DAMAGE TO RENTED <br />$ 100,00 <br />MED EXP (Anyone person) <br />$ 5,00 <br />A <br />PERSONAL aADVINJURY <br />S 1,000,00 <br />GENERAL AGGREGATE <br />$ 2,000.00 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS -COMPIOPAGG <br />S 2,000 00 <br />POLICY n jECT LOC <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />BA3466W34409 <br />01/26/2009 <br />01/26/2010 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />1,000,00 <br />BODILYINJURY <br />(Per Person) <br />$ <br />B <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />X <br />X <br />BODILY INJURY <br />(Per accident) <br />$ <br />X <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />ANY AUTO <br />OTHER THAN EAACC <br />AUTO ONLY: AGG <br />S <br />$ <br />EXCESSIUMBRELLA LIABILITY <br />X OCCUR CLAIMS LIADE <br />XSMCUP3459Y45909 <br />01/26/2009 <br />01/26/2010 <br />EACH OCCURRENCE <br />S 13000, 00, <br />AGGREGATE <br />S 1, 000, 00, <br />A <br />$ <br />S <br />DEDUCTIBLE <br />X RETENTION $ 10, 00 <br />$ <br />WORKERS COMPENSATION AND <br />WC STATU- I OTH- <br />EMPLOYERS' LIABILITY <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETORIPARTNEWEXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />Syyes,ALPR PROVISIONS <br />SPECIAL PROVISIONS below <br />E.L. DISEASE - EA EMPLOYEE <br />S <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />OTHER <br />APPROVED <br />AS TO FORM <br />DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br />ERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED PER FORM GN 01 88 01 96. <br />Laura t titt Sheedy <br />Assistant City Attorney <br />ANCELLATION NOTICE IS 10 DAYS IN THE EVENT OF NON-PAYMENT OF PREMIUM <br />CITY OF SANTA ANA <br />COMMUNITY DEVELOPMENT AGENCY M-25 <br />ATTN: FRANK HERNANDEZ <br />20 CIVIC CENTER DRIVE <br />SANTA ANA, CA 92701 <br />ACORD 25 (2001108) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br />Timothy Wiamore/G: <br />©ACORD CORPORATION 1981 <br />