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ACORD CERTIFICATE OF LIABILITY INSURANCE <br />6/2i 010 <br />PRODUCER (661) 287 -4195 FAX: (661) 254 -5875 <br />James G Parker Insurance Associates <br />License #0554959 <br />27200 Tourney Rd #350 <br />Valencia CA 91355 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <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 />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />Midori Gardens Inc <br />3231 Main St <br />Santa Ana CA 92707 <br />INSURER A: Star Insurance COMPany <br />18023 <br />INSURER B: - <br />INSURER C: <br />GENERAL LIABILITY <br />INSURER D: <br />INSURER E: <br />I OCCURRENCE <br />w v <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />AGGREG AT E LIMITS HO MAY HAVE BEN REDUCED BY PAID CLAIMS. <br />INSR <br />AOD'L <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MMIDD <br />POLICY EXPIRATION <br />DATE MM/DD <br />LIMITS <br />GENERAL LIABILITY <br />I OCCURRENCE <br />$ <br />DAMAGE TO RENTED <br />PR MI a occurrence) <br />_ <br />$ <br />COMMERCIAL GENERAL LIABILITY <br />MED EXP (Any one person) <br />$ <br />CLAIMS MADE 7 OCCUR <br />PERSONAL 8A V INJURY <br />$ <br />GENERAL AGGREGATE <br />S <br />PRODUCTS - COMP/ OP A <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRO - <br />POLICY LOC <br />AUTOMOBILE <br />LIABILITY <br />G <br />1 <br />COMBINED SINGLE LIMIT <br />ANY AUTO <br />A� <br />(1 <br />(Ea. accident) <br />$ <br />BODILY INJURY <br />ALL OWNED AUTOS <br />�T <br />R V <br />SCHEDULED AUTOS <br />(Per person) <br />$ <br />BODILY INJURY <br />(Per accident) <br />S <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />" <br />W& '021. 5�C, <br />- v <br />eQ,dynOY <br />ty �ttOt <br />��ti��St2nt <br />PROPERTY DAMAGE <br />(Per accident) <br />S <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />S <br />OTHER THAN EA A <br />$ <br />A NY AUTO <br />$ <br />AUTO ONLY: AGG <br />EXCESSIUMBRELLA LIABILITY <br />$ <br />AGGREGATE <br />$ <br />OCCUR CLAIMS MADE <br />S <br />$ <br />DEDUCTIBLE <br />RETENTION <br />A <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />A WC STATU- OTH- <br />I FIR <br />E.L. EACH ACCIDENT <br />$ 1 , O00 , 000 <br />ANY PROPRIETOR/PARTNER /EXECUTIVE <br />OFFICER /MEMBER EXCLUDED? <br />If yes, describe under <br />WC045330601 <br />6/1/2010 <br />6/1/2011 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />SPECIAL PROVISIONS below <br />OTHER <br />DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLE $[EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br />Job: City of Santa Ana <br />*10 day notice of cancellation IF policy cancels for non - payment of premium /non - reporting of payroll. <br />CERTIFICATE HOLDER ceurel I ATIn61 <br />(714) 647 -5069 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />City of Santa Ana <br />Attn: Jerry Jeffries <br />20 Civic Center Plaza <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />*30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br />Ross Annex (M -21) <br />FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br />Santa Ana, CA 92701 <br />INSURER ITS AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br />James Parker III /KFL 65A�'� <br />" "' `` "" " " "I 0 ACORD CORPORATION 1988 <br />INS025 (0im) 08a pane 1 of 7 <br />