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R <br />'`�r �•;7 <br />CERTIFICATE NUMBER <br />'H <br />• <br />4rERTIFICATa <br />4► <br />R 1 /�wIM <br />R I"l/�{J NYC-001296713-01 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br />PRODUCER <br />Marsh USA Inc. <br />NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE <br />4 Stamford Plaza <br />POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE <br />107 Elm Street <br />AFFORDED BY THE POLICIES DESCRIBED HEREIN. <br />Stamford, CT 06902 <br />Attn: Marybeth Torelli (203) 964-2678 <br />COMPANIES AFFORDING COVERAGE <br />COMPANY <br />33050-$lmm-umb-2002 <br />A FEDERAL INSURANCE CO <br />INSURED r �� <br />I <br />COMPANY `I <br />MBIA MuniSerivices Company ; <br />Attn: Shawn Bebee <br />3433 West Shaw Avenue <br />Fresno, CA 97311 <br />B PACIFIC INDEMNITY CO <br />COMPANY <br />C <br />COMPANY <br />D <br />C0VERAGES This cerii%6 #e supersede& and cep)aces any previously itsuiad'certifrcate for #he!-polloy period notdd low. <br />THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT <br />OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY <br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE <br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />—7 <br />CO <br />LTR <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 <br />LIABILITY <br />3529-18-62 <br />12/30/02 <br />12/30/03 <br />GENERAL AGGREGATE $ 2,00,000 <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE 1K OCCUR <br />PRODUCTS -COMP/OP AGG $ 1,000,000 <br />PERSONAL & ADV INJURY $ 1,000,000 <br />EACH OCCURRENCE $ 1,000,000 <br />OWNER'S & CONTRACTOR'S PROT <br />FIRE DAMAGE (Any one fire) $ 1,000,000 <br />MED EXP (Any oneperson) $ 10+000 <br />A <br />AUTOMOBILE <br />LIABILITY <br />7318-60-88 <br />12/30/02 <br />12/30/03 <br />COMBINED SINGLE LIMIT $ 1,000,000 <br />X <br />ANY AUTO <br />BODILY INJURY $ <br />(Per person) <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON-OWNED AUTOS <br />Cis i' �' iZo V �', D <br />;;,•� ., <br />A S <br />T� <br />�� FOR �1 <br />X <br />BODILY INJURY $ <br />(Per accident) <br />-� <br />PROPERTY DAMAGE $ <br />GARAGE LIABILITY <br />ANY AUTO <br />L. ? - ICCLIY <br />DCptl[v i.�lty Attorney <br />AUTOONLY- EAACCIDENT $ <br />OTHER THAN AUTO ONLY: <br />EACH ACCIDENT $ <br />AGGREGATE $ <br />A <br />EXCESS LIABILITY <br />7966-07-01 <br />12/30/02 <br />12/30/03 <br />EACH OCCURRENCE $ 1,000,000 <br />AGGREGATE $ 1+000,000 <br />X UMBRELLA FORM <br />$ <br />OTHER THAN UMBRELLA FORM <br />B <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />7160-85-83 <br />12/30/02 <br />12/30/03 <br />X WI TATU- OTH- , <br />,L <br />TORV LIMITS ER <br />EL EACH ACCIDENT $ 500,000 <br />THE PROPRIETOR/ INCL <br />PARTNERS/EXECUTIVE <br />F1 <br />EL DISEASE-POLICY LIMIT $ 500,000 <br />EL DISEASE-EACH EMPLOYEE $ 500,000 <br />OFFICERS ARE: EXCL <br />A <br />OTHER <br />Auto Deductible: <br />7318-60-88 <br />12/30/02 <br />12/30/03 <br />Collision: $1,000 <br />Comprehensive: $1,000 <br />A <br />UMBRELLA COVERAGE <br />7966-07-01 <br />12/30/02 <br />12/30/03 <br />UMBRELLA SITS ABOVE EMPLOYERS' <br />LIABIITY COVERAGE. <br />DESCRIPTION OF OPERATION S/LOCATIONSNEHICLES/SP ECIAL ITEMS <br />THE CITY OF SANTA ANA, ITS OFFICERS, SERVANTS, EMPLOYEES AND AGENTS ARE NAMED AS ADDITIONAL INSUREDS WITH RESPECT TO <br />THE WORK PERFORMED BY THE NAMED INSURED AS REQUIRED BY CONTRACT. "THIS MAILING WILL BE RECOGNIZED AS ACCEPTABLE <br />NOTICE." "60 DAYS NOTICE OF CANCELLATION SHALL BE PROVIDED TO THE FIRST NAMED INSURED PRIOR TO CANCELLATION OF A POLICY." <br />CERTIF[OA E. HOLDERCA <br />.U411101 <br />SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, <br />City of Santa Ana <br />Attn: Christine Calderon <br />THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL -In DAYS WRITTEN NOTICE TO THE <br />CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR <br />20 Civic Center Plaza <br />Santa Ana, CA 92702-1988 <br />LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE <br />ISSUER OF THIS CERTIFICATE. <br />MARSH USA INC. qq. <br />BY: Mac D. Nadel <br />MM1(3i112} VAUD A3OF: 12/27/02 - <br />