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r - <br />'r.�"1 OP ID: KG <br />CERTIFICATE OF LIABILITY INSURANCE <br />111 ' oww <br />081241'11 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOR AAT10N ONLY AND CONFERS NO RIGHTS UPON THE CERTIFIGIiE HOLDER. THIIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EffEW OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IRWRER(S). AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTFICATE HOLDER <br />IMPORTANT: If the carIfficats holder Is an ADDITIONAL INSURED, the poilcy(Ise) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and corWidons of the policy, certain policies may require an endorsement A satamnt an this cw0male does not oontsr rights to the <br />cadMcdo holder In Neu of such endorseme e <br />PRODUCER 90 888 Se'! <br />.OInsurance 909- 888 -2043 <br />T Kennail Goad <br />909-474.8770 909 - X88.2013 <br />940^& k Mgantinsurancs,COM <br />amm <br />36 CamegIs DdNro, Six 200 <br />San Bontsrdino, CA 92409 <br />Chuck Shsnklin, CIC <br />HOM-2 <br />EACH OCCUFIRENCR <br />APPDUIOEUa covERAOe NAIC a <br />.+euNao Houston A Harris PCS Inc <br />eIeIURC+I A :0 B E insurance Corp <br />EYED EXP Wq 9m Pwwj <br />21831 Barton Road <br />Grand Terrace, CA 92313 <br />ref mm a: Golden Eagle haurnnCe Corp <br />4 1 <br />mw= Union Fire ins Co <br />wsuwsN P: Everest National Irourance Co <br />$ 21 <br />GEWL AGGREGATE LEeTAPPUESPER: <br />vOLCY X M 7 LOC <br />INFA MIE: <br />$ A0 <br />RNtP• <br />B <br />AUTOMOBLE <br />COVERAGES _ CERTOCATE NUMBER: REVISION NUMBB b <br />THIS IS TO CERTIFY THAT THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REOU REMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />GERTiFiCATE WY BE k"UED OR MAY PERTAKN, THE INSURANCE AFFORDED BY THE PCVCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />INSR <br />Im <br />TYPE OP EWAtANCE <br />ADM <br />ON <br />POLICY NOMMER <br />Leif <br />A <br />GENERAL LIANUTY <br />X commERc1AL GHMERAL LIABILITY <br />CLAWS -MADE Fx-1 occuR <br />X <br />Mows <br />0812NM t <br />OW M 2 <br />EACH OCCUFIRENCR <br />$ 1.4� <br />PROAMB Me WanvMM <br />11 30 <br />EYED EXP Wq 9m Pwwj <br />I S <br />PERSONAL LADV EUURY <br />4 1 <br />GENERAL AGGREGATE <br />$ 21 <br />GEWL AGGREGATE LEeTAPPUESPER: <br />vOLCY X M 7 LOC <br />PRODUCTS - CONPfOPAGO <br />$ A0 <br />$ <br />B <br />AUTOMOBLE <br />LMBLTTY <br />ANYALrro <br />ALL OVMO AUTOS <br />SCHEOULEDAUTOS <br />WED ALlros <br />NON OVMDAUTOS <br />BANNNIVED AS TOOW&ANI <br />- <br />06/24112 <br />COMBINED SINME LIWT <br />1,000. <br />X <br />B0DiLYNIURYlvR+a+1 <br />s <br />eODlLrerwRYlwrs�Idwe1 <br />s <br />PROPERTY [1AAAAfAE <br />ePw.or+d�q <br />S <br />Laura Stitt She <br />AsSLStant City Att <br />dy <br />r ey <br />S <br />O <br />UMBROLLAUM <br />u" <br />X <br />OCCM <br />CLAMS -IAOE <br />E0207246" <br />111111 11 <br />"42112 <br />EACHOCCUNREAM <br />1 <br />X <br />AGGREGATE <br />3 $000 <br />DEOUCTIBLE <br />RETENTION I; <br />0 <br />D <br />*0MUM CONPBISATrDN <br />ANDEMPLOVENS UANKAY <br />ANY PRGPR:ETowARiTI�CLmVE YIN <br />O�Po c lop" EJ(CLUDE07 � <br />M <br />r de, rbeundidw ION OF OPERA <br />N ! 4 <br />600003267101 <br />DBID1110 <br />D91DIM 1 <br />X M/C STA OTH- <br />E.L. EWMACCIDENT <br />a 11000 <br />E.L. oISEAM - EA EMPLOYE <br />! 1,000 <br />E.L. Off-ASE - nAV LTWT <br />S 1 <br />EESORIPfION OP OPERATIONS / LDCATIDNS / wB ms 1 Ac 10 Adiftwo ma so dmek mom. �paa u nom" <br />ram. pertaining to named Insured for es"dholder. CRy Of Santa Ana and <br />I"d4wim aQaas ti errltans, 8 a MT'84 & C M <br />�9 P� end`tB 0020 O 0704 E CGZIi37 0704. <br />CI&AN06 <br />City of Santa Ana <br />Public Works Agency <br />M-80 <br />220 S. Daisy Ave <br />Same Ana, CA 92M <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED MOORE <br />THE EXPIRATION DATE THEREOF. NOTICE TAI LL I E DELIVERED IN <br />ACCORDANCE WrrH THE POLICY PROVISIONS. <br />AUrIONEW REPRSBMATNE <br />C/Z�-f <br />631980 009 ACORD CORPORATION. AN rVft resomml. <br />ACOROM (2009109) The ACORD narrle and logo an registered routs of ACORD <br />