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BIAI <br />• DATE (MM/DD/VYYY) <br />AC hDT CERTIIFItCAT OF LIABILITY INSUR CE <br />12/29/04 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Hilb Rogal S Hobbs <br />100 Park Avenue <br />14th Floor <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 />POLICY NUMBER <br />New York, NY 10017 <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURED <br />MBIA MuniServices Company <br />Attn: Patricia Kemsley <br />7335 N. Palm Bluffs Dr. <br />INSURER A: Hartford Insurance Company 19682 <br />INSURER B: Federal Insurance Company 20281 <br />INSURER C: <br />INSURER D: <br />Fresno, CA 93711 <br />INSURER E: <br />COVERAGES <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 />INSK <br />LTR <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MM/DD/YY <br />POLICY EXPIRATION <br />DATE MM/DD/YY <br />LIMITS <br />A <br />GENERAL LIABILITY <br />1000NTS9309 <br />12/30/04 <br />12/30/05 <br />EACH OCCURRENCE $1,000,000 <br />X COMMERCIAL GENERI�AL LIABILITY <br />CLAIMS 10ADE 1_J CCCUR <br />DAMAGE TO RENTED $50,000 <br />MED EXP (Any one person) 155,000 <br />PERSONAL & ADV INJURY $1,000,000 <br />GENERAL AGGREGATE $2 000 000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG $1,000,000 <br />POLICYPRO LOC <br />JECT <br />A <br />AUTOMOBILE LIABILITY <br />X ANY AUTO <br />1000NTS9309 <br />12/30/04 <br />12/30/05 <br />COMBINED SINGLE LIMIT <br />(Ea accident) $1,000,000 <br />X ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY $ <br />(Per person) <br />X HIRED AUTOS <br />X NON -OWNED AUTOS <br />BODILY INJURY <br />(Per accident) $ <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EA ACC $ <br />ANY AUTO <br />—0 <br />AUTO ONLY: AGG $ <br />B <br />EXCESS/UMBRELLA LIABILITY <br />X OCCUR F-1 CLAIMS MADE <br />10RHUTT0173 <br />12/30/04 <br />12/30/05 <br />EACH OCCURRENCE $5,000,000 <br />AGGREGATE s5,000,000 <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />WORKERS COMPENSATION AND <br />10WBKZ7580 <br />12/30/04 <br />12/30/05 <br />- <br />LIMITA <br />TORY WC STATU- OTHFIR <br />EMPLOYERS' LIABILITY <br />E.L.. F:A,. H ACCIrENT $500,001) <br />ANY PROPRIET(R/PARTNER/EXEC'JT1`.E <br />E.L. DISEASE - EA EMPLOYE $500,000 <br />OFFICER/MEMBER EXCLUDED? <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT $500,000 <br />SPECIAL PROVISIONS below <br />OTHER <br />AS TO FORM <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />THE CITY OF SANTA ANA, IT'S OFFICERS, AGENTS, SERVANTS AND EMPLOYEES ARE <br />NAMED AS ADDITIONAL INSURED'S WITH RESPECT TO THE OPERATIONS AND WORK_1.0 a Snit Speedy <br />PERFORMED BY THE NAMED INSURED AS REQUIRED BY CONTRACT. THIS MAILING WILL Stant City Attorney <br />BE RECOGNIZED AS ACCEPTABLE NOTICE. <br />CITY OF SANTA ANA <br />ATTN: CHRISTINE CALDERON <br />20 CIVIC CENTER PLAZA <br />Santa Ana, CA 92702-1988 <br />nr+non ee Senn l lne. <br />VMIY\iGLI-.M I IVIY <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL 1(VJMEU 9tX9(MAIL A0_ DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, J KXWA0= jJ =)=)=NX <br />AUTHORIZED <br />-5 G <br />-' --' "' A fFIYRJLL IJ AMC © ACORD CORPORATION 1988 <br />