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r1•...." een4'3 MRIAINC ACORD-M CERTIFICAISOF LIABILITY INSUR04CE DATE 01/07/04DnYYv> PRODUCER Hilb Rogal & Hamilton 1211 Avenue of The Americas 27th Floor (HRH) New York, NY 10036 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED MBIA MuniServices Company Attn: Patricia Kemseley 7335 N. Palm Bluffs Dr. Fresno, CA 93711 / INSURER A: Federal Insurance Company 20281 INSURER B: Pacific Indemnity Company INSURER C: INSURER D INSURER E: I.0 V C I[li V CJ LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING THE POLICIES OF INSURANCE TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ANY REQUIREMENT, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH MAY PERTAIN, POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY A GENERAL LIABILITY 35291862 12/30/03 12/30/04 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED $50,000 PREMISE Ea occurrence X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) s5,000 CLAIMS MADE � OCCUR PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $1,000,000 PRO- POLICY LOC JECT A AUTOMOBILE LIABILITY 35291862 12/30/03 12/30/04 COMBINED SINGLE LIMIT $1000000 X ANY AUTO (Ea accident) > > X ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS X BODILY INJURY $ HIRED AUTOS (Per accident) X NON -OWNED AUTOS PROPERTY DAMAGE $ X $1,000 Comp Ded X $1,000 Coll Ded (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: AGG $ A EXCESSIUMBRELLA LIABILITY 79660701 12/30/03 12/30/04 EACH OCCURRENCE s5,000,000 AGGREGATE $5,000,000 X OCCUR FICLAIMS MADE $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND 71608583 12/30/03 12/30/04 TORY LIMIT OER E.L. EACH ACCIDENT $500,000 EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE -POLICY LIMIT $500,000 If yes, describe under SPECIAL PROVISIONS below A OTHER Umbrella 79660701 12/30/03 12/30/04 Umbrella Limit is above the Employers Liability Limit DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS THE CITY OF SANTA ANA, IT'S OFFICERS, AGENTS, SERVANTS AND EMPLOYEES ARE NAMED AS ADDITIONAL INSURED'S WITH RESPECT TO THE OPERATIONS AND WORK PERFORMED BY THE NAMED INSURED AS REQUIRED BY CONTRACT. THIS MAILING WILL BE RECOGNIZED AS ACCEPTABLE NOTICE. 1,r_K I II'II,A I C MULUMM 1//11\I.GLLM I IVIN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF SANTA ANA DATE THEREOF, THE ISSUING INSURER WILL jtbt0Q q(jQji;MMAIL 10_ DAYS WRITTEN ATTN: CHRISTINE CALDERON NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, RKRWA0 SRliTQXX)5XrAdRjOX 20 CIVIC CENTER PLAZA jODPJORRRIOQIikI[KR9Q1C9I000ROG1pRXldICXCMCOOjtOU[Il9QiCRiE�[DC9LRi�R7lR9�ALiQFACSCjQRXXX Santa Ana, CA 92702-1988 IXNXMXKRW=XX AUTHORIZED REPRESENTATIVE � C -i 3 -1 ACORD 25 (2001108) 1 of 2 #M75660 JOH © ACORD CORPORATION 1988