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<br />??'®F2L?,w C???'I?ICA`I°E OF I.eIA?ILITY INSUF7ANC? 7TE(NI•.IDD 2) <br />PROnu DER <br />ORANGE PACSE'SC SNSCJRANCE AGENCY <br /> <br />17621 SrV].n E? Blvd $? 204 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT Ah'IEND, EXTEND OR <br />ALTER THE COVERAGE AFFO ROED 6Y THE POLICIES BELOW. <br />TvstinJCA 927$0 <br />71414$0=6 f380' <br />INSURERS AFFORDING COVERAGE <br />- _- <br />NAIGS <br />uJSVRED 1jAl. I S P INSURER A? GOLDEN EAGLE INS. CORPOItA7-'ION __ <br />J2LLSON & ROBERTS INS VRER B: <br />CASTOR ST <br />3300 W INSURER c: __ <br />- <br />. <br />CA 92704 <br />SANTA ANA _ <br />INSURER D: <br />J <br />7 -424-0111 INS VRER E: <br />TI'IE POLICIES OF INSU RANGE LISTED BELOW HAVE BEEN ISSUED TO TLIE INSURED NAMED ADOVE FOR TFIE POLICY PERIOU INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERhI OR CONDITION OF ANV CONTRACT OR OTHER DO CUAAENT WITH RESPECT TO WHICH THIS CERTIFICATE R'WY BE ISSUED OR <br />THE INSV RANGE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TFRf.{S. EXCLUSIONS AND CONDITIONS OF SUCH <br />MAY PERTAIN <br />, <br />POLICIES-AGGREGATE LIMITS SHOWN MAY}LAVE BEEN RE DUCED BY PAID CI AIMS. <br />usn <br />'Lift PrYI. <br />vsao <br />F OF INSU A! CE POLICY NU/aBER OLICY EFFECTNE <br />GATE GhVDD/YY POL CYEXPIRATION <br />D TE f.1?1?D OlW LI61fTS <br /> GENERAL LL4HIl1TY EACH OCCURRENCE $ 1 O <br /> }? CGidiIE RDIAL GENERAL LInBIL1TY PREf.113E5 Ea occvrerxe) 100 O O <br />3 <br /> CLAIMSf.1ADE O OCCUR ? - _ _ <br />hiED EXP(Anyona person) _ <br />- <br />5 rJ OOO <br />A CBP6162885 7/27/11 7/27/12 PERSONALa ADVINJURV s 1 000 000 <br /> GENERAL AGGREGATE S 2 OOO OOO <br /> GENL AGGREGATE LU.IfT APPLIES PER: PRODVCTS-CO!.1P/OP AGO S_ 1000,000 <br /> POLICY PRO- LOC <br />JECT <br /> <br /> AlJT Ol,10 BILE LIADILITY ) INGIE LILIIT <br />E lelu d?D 5 1 <br />OOO , OOO <br /> nNY.5VT0 l ? <br /> <br /> nIL OWNED AVTOS BODIIYI NJVfiY 3 <br /> SCf1EDULGO AUTOS (Per pela00) <br />py X IiIRED AU I'OS CHP$1612$$5 7/27/11 7/27/12 BODIIYINJURY <br />$ <br /> X NON-OYVNED AUTOS (Per ac@denl) <br /> <br /> DAF.AOE <br />PE OTY <br />P O 3 <br /> I <br />e <br /> GARAGE IIAHILrty AUTO ONLY-EA AGCIDE NT 3 <br /> <br /> nrvYAUTO OTNERTl1AN EAACC 5 <br /> AUTO ONLY: qGG S <br /> EXCBSSNIlBRELLALIABILITY EACH OCCURRENCE $ 2 OOO OOO <br /> }{ OCC VR C? CLlJ 1.15 !.1AOE AGGREGATE 3 2 OOO OOO <br /> c0$167785 7/27/11 7/27/12 3 <br /> -__.__-. <br /> DEDUCTIBLE <br /> <br /> RETENTION S 3 <br /> CS ATU- - <br /> WORKER6COr.1PENSAT101fAND YLIl.1 E <br /> EAIPLOYERS'LIABILITY <br />WC3790250 <br />7/27/11 <br />7/27/Y2 E. I. EACHnCC10ENT 3 1 OOO O_ <br />. _Oq <br />A ?NY PROP0.IETOR9.IRTNEILFYECViIVE <br />OTF¢EFinlCVBeR EY.CLUpEOp _ <br />EA EGIPIOYE <br />EL DISEASE _ $ <br />]-LOGO OOO <br /> GYOs tlasaibauntler <br />SPE?IAI PROVISIONS ee:alr , <br />6L DISEASE-POLICY Ul.IIi _ <br />S 1 OOO OOO <br /> OTHER <br />T(c eY.,? '? <br />.,v? <br />DESCRIPTION OFOPERATIONS/LOCATIONS/VEHICLESIEXCLUSIONSAODED BYENCORSEl.1ENTISPECIALPROVISION9 <br />l <br />/? <br />L <br />V iz U? <br />?CPS?O v?1/ <br />,. <br />?. c. <br />/? _. ? I __ ?._ _?-- <br />( __ <br /> <br />t City Attorney <br />Cit. O£ Santa Ana SHOULD ANV OFTHE ABOVE UESCRIBEO POLICIES BE ONJCELLEO BEFORE THE EXPIFL TION <br />y GATE TH[REOF. THE 1a SVIN'G INSV RER WILL ENDEAVOR TO IAAIL 3O pAYS WRITTEN <br />2O Ci V1C Canter Plaza NOTICE TO THE CERTIFICATE IIOLDER NA/AED TO THE LEFT, BVT FAILURE TO DO 50 SHALL <br />Santa Anal CA 92702 <br />IMPOSE !:O OBIIGAT101J OR LIABLE fTY OF ANY KIND UPON THE INSURER. 1T3 AGENTS OR <br />D 25 <br />TION <br />Exhibit C