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( YY`. CERTIFICATE OF LIABILITY INSURANCE opID IP DA TA (fi1MIDDi CPCPO-1 05/26/1 rrcvuu?en I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION United Agencies, Inc. (H) I ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE < A_ License #x0252636 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 11 Bonita Ave. , Ste . A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. _a Verne CA 91750 Phone: 909-593-7776 Fa;1: 909-593-5477 INSURERS AFFORDING COVERAGE NAIC V INSURED INSURER A Lloyd's of London INSURER E. CPC Powertec, Inc. sNSURERC --- ------- 31441 Santa Margarita Pr. A390 ;INSURER, D. Rancho Santa Margarita CA 92688 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOih' HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE NW. BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES CE SCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ? - TS -..___ S LTR NSR TYPE OF INSURANCE POLICY NUMBER _...Y EXPI .._. P._.ATI T-1 -ON---......._._. ...... i POL1Cl' FECTIV E IPOLtC EF .' DATE rMM/DDJYYYY) IDATE (MM/DDNYYY) LIPJITS j GENERAL LIABILITY - 1 !EACH OCCURRENCE j $ 1 000 000 r 1 h i X „- COMMERCIAL GENERAL LIABILITY YUSA4100299 DAN4A'GETU_R-t `TED" - 05/-24/10: 05/24/11 PREMISES (Ea occurence) ? 250,000 ?'. j CLAIMS MADE OCCUR _ MED EXP (Any one person) s 5,000 - - ? PERSONAL a ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 ? I Gch"c AGGREGATE LIMIT A?PLIES PER: J PRODUCTS • COIvIP/OP AGG S 1,000,000 X POLICY I LO { I - C : JEC T i AUTOMOBILE LIABILITY j COMBINED SINGLE LIMIT ANY AUTO NOT COVERED r (Ea accident) S ALL OWNED .AiJT05 BODILY INJURY I SCHEDU ED AUTOS (Per person) I _ HIRED AUTOS _ BODILY INJURY-? S NON-OWNED AUTOS i (Per accic_nt) _ ?- - - I i - PROPERTY DAMAGE r j - - (Per acadent) " ) GARAGE LIABILITY ? I AUTO ONLY - EA ACCIDENT S ANY AUTO NOT COVERED j OTHER THAN r, ACC j £ .??.. UTO ON= AGCT `T` ll 01- ? l? 'UMBRELLA j EXCESS LIABILITY EACH OCCURRENCE I W OCCUR. CLAIMS MADE NOT COVERED jl AGGREGATE-5- ?-' DEDUCTIBLE -aura Stitt eedy i ? 1 g i y ?[ RETENTION g i + - s,istaw City. Attorney ?..$---- j WORKERS COMPENSATION ) . D LOY ' C ; • { ry_i TO Y I I i AN EMP ERS LIABILITY Y/Nj R LIM TS _? ER ? ANY PROPRIETOR/PARTNER/EXECUTIV NOT COVERED E.L. EACH ACCIDENT ` S OFFICER/MEMBER EXCLUDED? r (Mandatory in NH) ) E L DISEASE -EA. EMPLOYEE! $ If yes, describe under SPECIAL PROVISIONS below j ' E.L. DISEASE -POLICY ! IMIT 3 OTHER I I A TERRORS/OMISSIONS YiJSA41C0299 05/24/10 05/24/17 Per Claim 1,000,000 ILIA--Claims Made ` I Aggregate 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES) EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS *EXCEPT 10 DAYS NOTICE OF CANCELLATION APPLIES FOR NONPAYE:NT OF PREMIUM. r\ i U-1- I L I I V 1-rX ,SANTAAN SANTA ANA PUBLIC WORKS WATER DIVISION- (M85) 220 S. DAISY AVE SSANTA ANA CA 92703 ACORD 25 (2009101) t;ANL:tLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRIT T EN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE © 988-2009 A t The ACORD name and logo are registered marks of ACORD TION. All rights reserved-