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.a►�co� o® CERTIFICATE OF LIABILITY INSURANCE 8/4/2010 ' PRODUCER (425) 455-5640 FAX: (425) 455-6727 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Baldwin Resource Group ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO Box 1848 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Bellevue WA 98009 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Ame=1Can States IMS CO 19704 TECHNOLOGY UNLIMITED INC N5URER B._ General Ins CO. O£ America 24732 1179 ANDOVER PARK WNSURER C- N ' — n /�\ I D' ' \VI G/�/l/// I INSURER D: TTJKWILA WA 96166 INSURER E: —ween—_ -- THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OFSUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADD'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION'. LTR N RD TYPE FINSURANCE GATE MMD AT MM O LIMITS X GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY 0 MAGE TO RENTED PREMISES Ea occurrence) $ 1,000,000 A CLAIMS MADE OCCUR 01CI26415520 8/4/2010 8/4/2011 MED EXP(—n one Parson) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 2,000,000 X POLICY PRO LOG AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO (Ea accident) B ALL OWNED AUTOS 24CC27258920 8/4/2010 8/4/2011 BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Par accident) GARAGE LIABILITY T�T� `' L- FORM APl 'L�(-)M LL� AS TO FORM ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA AGC $ AUTO ONLY: qGG $ EXCESS / UMBRELLA LIABILITY ,. EACH OCCURRENCE $ 4,000,000 OCCUR �� CLAIMS MADE - AGGREGATE $ 4 ,8C1 000 , 000 \..,. �,lauIt City Attorney $ A DEDUCTIBLE OISU41486220 8/4/2010 8/4/2011 $ X RETENTION $ 10,000 $ A WORKERS COMPENSATION WC STATU- OTH- X AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFI CE R/MEMBER EXCLUDED? F—] (Mamiatory In NH) 01CI26415520 8/4/2010 8/4/2011 EL. DISEASE - EA EMPLOYEE' $ 1,000,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1 000 000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS The City of Santa Arca, Ita officers, agents, volunteers and representatives era primary additional reapeCt to liability arising out of the operations by or on behalf of the named insured as per attached CG 7635 and CG76B0 il0 days notice for non payment (714)647-5304 City O£ Santa Ana Attn: Mirella Vargas 20 Civic Center Plaza Santa Ana. CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30' DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE Kevin Lane/MEL © 1988-2009 ACORD CORPORATION. All rights reserved. FrvaUZO (20090'1)_01 1 ne ^uut<o name ane logo are reglsterea marKs or sacL mu