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DATE (MM /DD/YYYY)
<br />ACORN ERTIFICATE OF LIABILITY INSURANCE 02/09/2011
<br />PRODUCER 925.934.0505 FAX 92 S .977.1591 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Insurance Associates of Northern CA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />1550 Parkside Drive, Suite 120 �Fl HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />� C1v ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />Walnut Creek, CA 94596
<br />w`\`\ i
<br />-�� _ r _ CE? �� �.� 1 U S AFFORDING COVERAGE -_ _ _. _ NAIC # _ __
<br />INSURED DOWney Vendors, InC. INSURER A: Travelers Prop Cas Co of America
<br />,.. Great American Insurance Co
<br />- -
<br />6814 Suva Street C j T `� - -- __ -- - --
<br />+N (kRFrR� _..
<br />e `:. .Itv�ut��'c
<br />Bel l Gardens , CA 90201 C t_ - mtsuRER D:
<br />- - - -- --
<br />__
<br />INSURER E:
<br />CrIV FO Af]CC
<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 />LTR
<br />DD'
<br />NSR
<br />�
<br />TYPE OF INSURANCE
<br />POLICY NUMBER
<br />POLICY EFFECTIVE
<br />DATE MM /DD/YYYY
<br />POLICY EXPIRATION
<br />DATE MM /DD/YYW
<br />LIMITS
<br />GENERAL
<br />LIABi LITi
<br />26601430C752TIL11
<br />02/09/2011
<br />02/09/2012
<br />EACH OCCURRENCE
<br />$ 1 , OOO , OO
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />AMAG` TO- RENTE[S
<br />PREMISES (Ea occurrence)
<br />__
<br />$__
<br />r__
<br />CLAIMS MADE � -� OCCUR
<br />MED EXP (Any one person)
<br />__ _ _ _1_0_0__,_0_0__
<br />$ S , OO
<br />_- -_-
<br />PERSONAL 8 ADV INJURY
<br />A
<br />$ 1 , OOO , OO
<br />GENERAL AGGREGATE
<br />$ 2 , OOO , OO
<br />__
<br />GEN'L AGGREGATE LIMIT APPLIESPER:
<br />PRODUCTS - COMP /OP AGG
<br />$ 2 , OOO , OO
<br />PRO -
<br />X POLICY JECT LOC
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />$
<br />—
<br />ANY AUTO
<br />(Ea accitlonl)
<br />BODILY INJURY
<br />- --
<br />ALL OWNED AUTOS
<br />SCHEDULED AUTOS
<br />(Per person)
<br />$
<br />i
<br />HIRED AUTOS
<br />BODILY INJVRY
<br />$
<br />I
<br />r-
<br />NON -OWNED AUTOS
<br />(Per eccitlent)
<br />_. _ __. _._
<br />_.... -._
<br />4 - -___.
<br />_. .. _..._ _____ ___- _
<br />PROPERTY DAMAGE
<br />$
<br />�,
<br />(Par accitlent)
<br />GARAGE
<br />LIABILITY
<br />AUTO ONLY - EA ACCIDENT
<br />$
<br />.. __.. _ -__ --
<br />r--
<br />__
<br />- _ - -
<br />EA ACC
<br />ANY AUTO
<br />$
<br />AUTO ONLY: qGG
<br />$
<br />EXCESS /UMBRELLA LIABILITY
<br />SBU019923500
<br />02/09/2011
<br />02/09/2012
<br />EACH OCCURRENCE
<br />S_,_O_OO,OO_
<br />X OCCUR a CLAIMS MADE
<br />__
<br />AGGREGATE
<br />_$_ _
<br />$ S , OOO , OO
<br />B_-
<br />__.. _. _
<br />_. - _.__ - -_.
<br />�
<br />_
<br />$ �. .
<br />�
<br />DEDVCTIB�E
<br />j
<br />rX
<br />�
<br />RE�LNTIiJt. $ ). S�, tFOO�
<br />$
<br />WORKERSCOMPENSATON
<br />IJUB1215L86710
<br />04/01/2010
<br />04/01 /2011
<br />X_LoRVL�TS� LeR
<br />_._ _-
<br />AND EMPLOYERS' LIABILITY
<br />_.
<br />E.L. EACH ACCIDENT
<br />- - --
<br />A
<br />ANY PROPRIETOR /PARTNER/EXECUTIVE�
<br />S 1 , OOO , OO
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />EL DISEASE - EA EMPLOYEE
<br />- - - - --
<br />$ 1,000 , OO
<br />If Yes, describe under
<br />SPECIAL PROVISIONS below
<br />-- __ - - -- -- - -- -__ --
<br />E.L. DISEASE - POLICY LIMIT
<br />-- - - -_ --
<br />$ 1 , OOO , OO
<br />OTHER
<br />`O�
<br />�QY
<br />DESCRIPTON OF OPERATIONS / LOCATONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS
<br />ante Ana City Hall, Santa Ana Police Dept., Santa Ana City Yard and Santa A brary Same' na,
<br />'ts officers, employees, agents, volunteers and representatives are inclu s addi pa4�sured
<br />er attached form #CGD2480805 as respects work performed by the named in,� gg�ge,��s primer Y
<br />s required by written contract. P �:, ��
<br />o
<br />°10 Da for a ment non- a ment of remium ,5�a
<br />�.CRllr Il.A1C RVLUCR GAIVGCLLAIIVIV - C�
<br />SHOULD ANY OF THE ABOVE DESC� OLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ''`3O DAYS WRITTEN
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
<br />c, ty of Santa Ana IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
<br />20 ClV7C Center, 8th Floor REPRESENTATIVES.
<br />Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE
<br />Stace Smith SSMITH
<br />ACORD 25 (2009/01) ©1988 - ?9a9 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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