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?R?® CERTIFICATE OF LIABILITY INSURANCE OP ID EC DATE (MM/DD/Yl'YY) <br />10 1B 10 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />^.ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />.FLOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />r2EP RESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />R N the certificate hol er Is an ADDITIONAL I U E , t e po Icy(ies must a en orse S OG ION IS AI ,subject to <br />the terms and conditions of the policy, certain policies mey require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder In Ileu of such endorsement(s). <br />PRODUCER <br />NAME: <br />Sawyer Cook Sn eurance A? Ha gxt?o _.._-_.._ _._ _(A/?..I±?2: _- _ _ <br />1200 Cali £ornia 3t. Sta 260 ?RESS: _ ??? <br />Radl ands CA 92374 cusro?A? MEN R?? PE RFO-7 <br />Phone: 909-435-0230 Fax 909-798-7971 --- - --- -- - <br />INSURER(S) AFFORDING COVERAGE NAIC q <br />INSURED _____.. .............--.. --.-..__ <br />INSURERA:_ Hart£Ord In9 uran C6 COmp8 ?, 22357 <br />Partnarsnca Excellence INSURERS Philadelphia Insurance <br />Shannon Salido INSURERC: <br />20911 Cabrillo Lana - - - -- ----- ---- -- -- _. _.? <br />Huntington Beach CA 92646 INSURER O: <br />INSURER E <br />INSURER F <br />THIS IS TO CERTIFY THAT THE POLICIES OF INS VRANGE LISTED BELOW HAVE BEEN ISSVED TO THE INSURED NAMED ABOVE FOR THE PO <br />LICY PERIOD <br />INDICATED. NOTW ITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W ITH R <br />ESPECT TO W HICH THIS <br />CERTIFICATE MAY BE ISSVED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUB <br />T <br />JEC <br />TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />____ _ _ <br />LTR TYPE OF INSURANCE ?-ADD B?_ - EFF -TtST_TCY D(y? - '-- - --' <br />INSR WVD' POLICY NUMBER (MM/DD MM/DD LIMITS <br /> GENERAL LIABILITY <br /> EACH OCCURRENCE <br />"_.__ <br />- <br />- $ 1 OOO, OOO <br /> <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />72$SAHOB229 <br />09/2T/10 <br />09/27/11 E <br />IUIiER <br />fED <br />PREMISES Ea occurrence ._- <br />$ 3OO OOO <br /> CLAIMS-MADE ? OCCVR <br /> _ MED EXP (grry one parson) $ 1 O , OOO <br /> - --.--.._ ... X PERSONALBADV INJURY-. $1 OOO,OOO <br /> <br />GENERAL AGGREGATE _- <br />$2,000,000 <br /> GENT AGGREGATE LIMIT APPLIES PER: <br />_ ? PRODVCTS -COMP/OP AGG S 1 OOO OOO <br /> <br />POLICY JEGT LOC <br />? <br />?____._.. _ __ <br /> AVTOMOBILE LIABILITY <br />-__ COMBINED SINGLE LIMIT $ <br /> <br /> <br />A <br /> <br />ANY AUTO <br /> <br />72 SSAHO8229 <br /> <br />09/2T/ <br />(Ea eccitlent) 1 , OOO <br />, OOO <br /> ? <br />ALL OW NED AUTOS 10 09/2T/11 BODILY INJURY IParP rso ) $ -- <br /> _ <br />SCHEDULED AUTOS <br />( ! ? T <br />1 <br />l-t <br />F?R __ <br />DOILY INJVRY IPar accltla I) _ __ _ <br />$ <br />-- <br /> X I HIRED AUTOS ?PpROVE ? PROPERTY DAMAGE <br />(Par acdtlenl) $ <br /> X__I NON-0WNED AVTOS <br /> CK -- _ - $- --- <br /> UMBRELLALWB <br />t <br />YtOrneY <br />EACH OCCURRENCE <br />S <br /> EXCESS uAB <br />___.. .._ ti <br />CLAIMS-MADE <br />? - <br />/>,SStSt nt ?i q <br />y AGGREGATE g _. <br /> - i , - <br /> DEDUCTIBLE / <br />$ <br /> <br />RETENTION $ l .-_ _ _ <br />$ <br />A WORKERS COMPENSATION <br />AND EMPLOYERS' 4ABILITY L+'E GLZ 13 09/2-!/10 <br />? 09/2T/11 A - <br /> \, / N <br />ANY PROPRIETOR/PARTNER/EXEGUTIV <br />OFFICER/MEMBER EXCLUDEDP ? <br />I <br />/A TORY LIMITS R <br />_- .__..... E <br />EL EACH ACCIDENT <br />-_._ -. _...... <br />$1 OOO, OOO <br /> (Mentletbry In NH) <br />11 es, tlescrlbe untler I E.L. DISEASE - EA EMPLOYE $ 1 , OOO , OOO <br /> <br />DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 5 1 OOO OOO <br />A Property Sacti on 7258ABOB229 os/zT/1o o9/zT/11 bpp 15,000 <br />H Pro£es sional Liab PHSD561724 os/zT/1o o9/zT/11 eacl-i occ 1 000 , 000 <br />DESCRIPTION OF OPERATION91 LOCATIONS /VEHICLES (Agacl, ACORD 10'i, Atltlltlbnal RembrftB Schotlule, IL more BpecB fa ragUlretl) <br />City o£ Santa Ana is named as an additional insured as their interest may <br />a <br />ppear. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City o£ Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />Community Development Agency .. <br />C)-lri5 Dalton AVTHORIZEp REPRESENTATIVE <br />20 Civic Center Plaza, M-25 <br />Santa Ana CA 92702 /) - !/ <br />I ?ri?.C /,?j <br />©1 -2009 ACORD C <br />ACORD 25 (2009/08) The ACORD name and logo are registered marks of ACORD