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ACORD CERTIFICATE OF LIABILITY INSURANCE <br />TM DATE(MMIDDIYYYY) <br />02/08/2011 <br />PRODUCER 818.274. 5627 FAX 818.274. 5631 <br />Stone, Harris & Stone A Division of <br /> <br />Brown & Brown of CA, Inc. 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 />21051 Warner Center Lane Suite 210 <br />Woodland Hills Ca 91367 <br />2911 APR 6 PM <br />SURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED CONSENSUS, INC. NSURERA: The Travelers Indemnity Co 25658 <br />626 Wilshire Blvd. INSURERB: Travelers Prop. Cas. Co of Ameri ca 25674 <br />Suite 1000 CIT)r ;'i;vSURERc: Gemini Ins. Co. 10833 <br />Los Angeles, CA 90017 CLE, <br />R INSURER D: <br /> INSURER E: <br />CnVFRAnFR <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />ANY REQUIREMENT <br />, <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 DD' <br />NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE <br />DATE JMMIDDIYYYY) POLICY EXPIRATION <br />DATE MM/DD LIMITS <br /> GENERAL LIABILITY 680-1631M951 03/17/2011 03/17/2012 EACH OCCURRENCE $ 2,000,00( <br /> X COMMERCIAL GENERAL LIABILITY <br />DAMAGE TO RENTE <br />REMISES Ea occurrence <br />P <br /> <br />$ 300,00( <br /> CLAIMS MADE Fx_1OCCUR MED EXP (Any one person) $ 5,00( <br />A PERSONAL & ADV INJURY $ 2,000,00( <br /> GENERAL AGGREGATE $ 4,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,00( <br /> X POLICY PRO LOC <br />JECT <br /> AUT OMOBILE LIABILITY 680-1631M951 03/17/2011 03/17/2012 COMBINED SINGLE LIMIT <br /> ANY AUTO (Ea accident) $ 1,000,00( <br /> ALL OWNED AUTOS BODILY INJURY <br />$ <br /> SCHEDULED AUTOS (Per person) <br />A X HIREDAUTOS <br />BODILY INJURY <br /> <br />X <br />NON-OWNED AUTOS <br /> <br />(Per accident) $ <br /> PROPERTY DAMAGE <br /> <br />X <br />No Owned Autos <br />(Per accident) $ <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS/ UMBRELLA LIABILITY CUP-9253Y260 03/17/2011 03/17/2012 EACH OCCURRENCE $ 1,000,00 <br /> X OCCUR F-ICLAIMS MADE AGGREGATE $ 1,000,000 <br />B $ <br /> DEDUCTIBLE $ <br /> X RETENTION $ <br />- $ <br /> WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />TAT OT11 <br />- - <br />TORY LIMITS ER <br /> ANY PROPRIETORIPARTNER/EXECUTIVEa ij <br />y R ??1) /?i;j t?j FORM E.L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ <br /> If yes, describe under <br />SPECIAL PROVISIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$ <br /> OTHER <br /> Laurzi St:tyl St eedy <br /> i <br />?ts?ant C',LV ? <br />ttorney <br />DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br />: Project Santa Ana Fixed Guideway System <br />ty of Santa Ana, its officers, employees, agents, volunteers and representatives are included as <br />ditional insured under the General Liability policy as required by written contract. <br />[ <br />aiver <br />of Subrogation Applies <br />xce t 10 days notice for cancellation due to non-payment. <br />CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN <br />Clerk of the City Council NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />20 Civic Center Plaza (M-30) IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />PO Box 1988 REPRESENTATIVES. <br />Santa Ana, CA 92702-1988 AUTHORIZED REPRESENTATIVE c ? rp.? . <br />Y cJ' b// '/ <br /> Victoria Stone/PPD <br />ACORD 25 (2009/01) FAX: 714.647.6956 © 1988-2009 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD