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'?°R° CERTIFICATE OF LIABILITY INSURANCE OP ID EC DATE(MMIDDIYYYYI <br />10/18/10 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />^.ERTIFICATE DDES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, E)<TEND 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 />IiEP RESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />fhe cart ante o Er Is an AL U , t e po ey es must a en ores IS I , su )act to <br />the terms and con ditlons o1 the pollay, eenteln poll ciDS may require an endorse msnt. A siaiement on this eertlflcate does not confer rlgMS to the <br />certl£cate holder In Ileu of such an dorsement(s). <br />IOOUCER <br />NAME: <br />S awyar Cook Insurance Nb Es!1__-_ ___.-...._..-____. _ ............. __--_. ..lA?--1+?2? _. <br />1200 California 9t. Sta 260 ADD ER as: -?? - <br />adlands CA 92374 sTn? M? E?lo. pERFO 7 <br />Phone: 909-435-0230 Fax: 909-798-7971 - --.'--- -- -- -?-? <br />-- -_-_ INSURER(S) AAOROMp COVCRADE NAIC p <br />iURED <br />INSURER A: Hartford Ina uranc® Compares 22357 <br />Parf ormanata Excallen ce ?- -?--'--- _ -- <br />Partnara INSUIteR e: Ph it adalph is Insurance <br />S annon $a l.i dp INSURER C <br />20911 Cabrillo Lana - ----- --- -.-- -. -... __. _. _.. _. <br />Huntington Haach CA 92646 INBURER D: <br />INSURER C; ?- ? ?- -? _ <br />INSURER R <br />7VE RAGES rteo•rtrtr n,•e w operas. _-_ ____ _. _ <br />s,YC accrv IsautO TD THE INS VRED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTW RHSTANDINO ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO W HIGH THIS <br />CERTIFICATE MAY BE ISSVED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TE0.M5 <br />, <br />EXGLUSIDNS ANp CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REO UCEO BY PAID CLAIMS <br />. <br />Lip TYPE OF INSURANCE NSR WV ' POLIO NUMSER M D M11. /bbMWY LIMITS <br />QENERAL LIgaIL1TY <br />EACH OCCURRENCE <br />S 1 OOO QQQ <br />__ <br />A X CDMMERCIIU_GENERAL LIABiLT' 72$HAHOB229 Oe/Z7/10 09/27/11 PREMISES (EE7?a?oncs) 53QQ QQQ <br />CLAIMS.MAOE ? DCCVR <br />MED EXP (Any ono pMaon) S lO , OOO <br />- ------ X PERSONKBADV INJURY S 1 QQQ QQQ <br />GENERAL AGGREGATE 52, QQQ, 000 <br />OEN'L AGGREGATE LIMIT APPLIES PER: <br /> <br />.._.... <br />PRODVCT6-COMP/OP AGG S 1,000, OOO <br />?.-._..-- <br />__ <br />POUCY EP LOC <br />5 <br /> gVTOMOaII! LIA6IUTY COMBINm 61NGLE VMR <br /> <br /> <br />A <br /> <br />_ <br />_ ANY AUTO <br /> <br />72 $HABOB 229 <br /> <br />09/27/10 <br /> <br />09 <br />27 <br />1 <br />(Ea ecNtlpnq <br />--- $ 1' QQQ I QQQ <br /> ? <br /> <br />ALL OWNED AUTOS / <br />/ <br />1 <br />BODILY INJURY IPpr person) <br />____-_____-_ ?-- <br />S <br /> <br />SCHEDULED AUT05 <br />' As rr <br />FO <br />ODILV INJURY IPef eotltlenl7 <br />----?- ___ _-__ <br />S <br />-?- -_-- -- ?-??--?- <br /> X HIRED AUTOS <br />-- ??RO? - PROPERTY DANWGE <br />(Per acdbenl) S <br /> X NON?OW NED AI <br />ITOS >? s "' <br /> , <br />w / <br /> _ CK - ---- -- - s <br /> VMSRELLA LIAB <br />[ <br />[[OrneY <br />EACH OCCURRENCE <br />S <br /> C%CC9S LIAR <br />CLAIMS-MADE <br />f> <br />g'S?S[ J <br />y <br />n[ Ct - <br />, <br />.. _. _. <br />AGGREGATE .._ _ ..._._....._ <br /> __ <br />DEDUCTIBLE , <br />---- -- S <br /> <br />S -. _..- <br /> RET ENrION 5 ? --_.- - _._ _.. . _ <br />A WORXERS COMPENSATION GLZ S <br /> <br />AND EMPLOYERS•4A01LITV 1,IN 09/27/10 09/27/11 <br />TORY UMITS <br />R <br /> <br />ECUTIVF{-? <br />V <br />H <br />M <br />ER? <br />A <br />R <br />LUE __ _ __ __ _ <br />? <br /> OFF <br />ICE <br />rtAE <br />B <br />F. <br />Jf <br />C <br />DEDi <br />u <br />(MSntlsto <br />In NH Iw _EL EACH wGCIOENT _ 5 1 <br />OOO 000 <br />L-_.-_ <br /> ry <br />) <br />11 ym. tlaSCnbe unbar <br />OE3CR E.L. DISEASE _EA EMPLOYE S liQ?QOQ <br />- <br /> <br />IPTDN OF OPERATIONS below E.L. DISEASE -POLICY LIMIT S 1 QQQ QQQ <br />A Propmrty $®cti on 72 S)3AHOB229 os/z7/1o op/z7/11 bpp 15,000 <br />H pro£cs ai onal Liab pHSD561724 oa/z7/1o o9/s7/11 eaoh occ 1 000 000 <br />DESC <br />Ci t RIPTION OF OP@RATIONS l LOCATIONS / V CNICLES (Atbcll <br />v o£ sar, t•_sa a., >. a ..emea .? -. .. gCORD lei`Aeeltlbntl Remmb SchbE(Ila <br />..,aaa _.-_ , 1/ mole apace V rpubptl) <br />aypmar . <br />..ol <br />City of Santa Ana <br />Community Development Agency <br />Chris Dalton <br />20 Civic CGa tar Plaza, M-25 <br />Santa Ana CA 92702 <br />I <br />SHOULD ANV OF THE ABOVE OE SCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />® -2008 ACORD C <br />ACORD 25 (2009/08) Tfie ACORD name and logo are reglBTe red marks of ACORD