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~. <br />~~ CERTIFICATE OF LIABILITY i <br />NSURANCE OP ID SK DATE(MMlDD,YYYV) <br />PRODUCER DAVIS-1 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 09 <br />Riviera Insurance Service, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />3710 State St. Suite 8 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Santa Barbara CA 93105 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Phone:805-880-4260 Fax:805-880-4259 <br />INSURED INSURERS AFFORDING COVERAGE NAIC # <br />INSURER A, aartPOrd Casualty Sneuranoe Go <br />Davs.s Resaarch, LLC INSURER B Evaraat national Inauranoa Co. <br />Attn' MrS{, ~T®nnyfes Davis .INSURER C' <br />23801 Calabasas Rd. Suite 1036 <br />Calabasas CA 91302 INSURER D: <br />COVERAGES INSURER e. <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 8E 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 MAV HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR NSR TYPE OF INSURANCE POLICY NUMBER „~ LIC___ FFE NE L v rwrwnr <br />GENERAL LIABILITY <br />A X X COMMERCIAL GENERAL LIABILITY 72SHAUC18273 <br />CLAIMS MADE ~ OCCUR <br />GEN'L AGGREGATE LIMIT APPLIES PER' <br />---I POLICY I,.._..-I PRO' I----l LOC <br />JECT f <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />_ NON-OWNED AUTOS <br />OARAGE LUU3ILITY <br />ANY AUTO <br />- - ""' T ~ UMITB <br />EACH OCCURRENCE <br />04/12/09 04/12/10 $ 2, 000, OOO <br />pREMISES(Eaoccurence $ 300 000 <br /> <br />MED EXP (qny one person) _ <br />$ 10 ~ OOO <br />PERSONAL &ADV INJURY $ 2, OOO, OOO <br />GENERAL AGGREGATE $ 4,000, OOO <br />-PRODUCTS-COMP/OPAGG $4,000,000 <br />F~ ,~ ;: <br />R~ ~ <br />~4gp•~EU _ ~ KA ..••p <br />~'~ . ..t ~,~ty p'~K;~ <br />EXCESS / UMBRELLA LIABILTY ~- <br />A X OCCUR ~ CLAIMS MADE 72SBAW8273 <br />DEDUCTIBLE <br />X RETENTION $ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LUU3ILITY <br />$ ANYPROPRiETOR/PARTNERlEXECUTI Y!N <br />OFFICER/MEMBER EXCLUDED? ~ 6000002452091 <br />(Mandatory in NH) <br />COMBINED SINGLE LIMIT <br />(Ea accident) $ <br />BODILY INJURY <br />(Per person) $ <br />BODILY INJURY <br />(Peraccidenq $ <br />PROPERTY DAMAGE <br />(Per accmenQ $ <br />I AUTO ONLY - EA ACCIDENT $ <br />I~ OTHER THAN EA ACC $ <br />AUTO ONLY <br />AGG $ <br />EACH OCCURRENCE $ 3 , 0OO 000 <br />04/12/09 04/12/10 AGGREGATE $ 3, 000, 000 <br />E <br />_.. $ <br />09/30/09 09/30/10 E.L. EACH ACCIDENT $ 1 , 000, 000 <br />E.L. DISEASE-EAEMPLOVEE $ 1,000,000 <br />E.L. DISEASE -POLICY LIMIT $ 1, OOO , OOO <br />utst:RiPTION OF OPERATIONS /LOCATIONS !VEHICLES !EXCLUSIONS ADDED BY ENDORSEMENT / SPECWL PROVISIONS <br />Certificate Holder is Additional Insured as respects to the General <br />Liability regarding a work project for the City of Santa Ana from 1/12/10 to <br />1/16/10. Primary and Non-Contributory; See attached Additional Insured <br />Endorsement for Commercial General Liability Policy supplemental form; <br />*Except 10 days notice of cancellation due to non-payment of premium, <br />CERTIFICATE HOLDER <br />CANCELLATION <br />BHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO <br />C'IT--20 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *3O DAYS WRITTEN <br />ity of Santa Ana; Community <br />NOTICE Tp THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE 70 DO SO SHALL <br />Development Agency; Deputy City IMPOSE NO OBIJOATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />Manager for Development SrvOB REPRESENTATNES. <br />20 C`iViC Center Plaza, M-25 AUTHORI76pR pRESENT~TNE ~ ~ ~ ~~ <br />Santa Ana CA 927ni ~ JJ // <br />2b (2009/01) - ~~ ~/ <br />The ACORD name and logo are reg[stered markss of <br />