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Home My WebLink AboutOMEGA GROUP, THE 2 - 2003r AGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in ~~ct~~~ ~ ~ ~~`~~~ ~' ~~ v Return form to the Sr. Deputy Clerk of the Council (M-30). Call 647 ~ ~~.if you have ~n,y' .;`~ questions. ='-' ----------------------------------------------------------------- The agreement with ~ ' ~. ~ ~ ~ , No. ~ ~~~'~ ~~---~ w , was completed on ~ ~ ~`'~ ~ ~, ~; ,and final payment has been made. Department: Signature: _ , f,~i~,~ n~N ~/i/X1.~J Date: ~ ~ ~ ~~ 'City of Santa Ana ; Revised 8-7-03 Clerk of the Council INSURANCE ON FilE WORK MAY PROCEED UNTl\.INSURANCE EXP ES 6 - J.. 7 -c . CIHI\ OF COUNCil DATE: i1-/7-tJ3 CPb h.:till This agreement, made and entered into July 1,2003, by and between the City of Santa Ana, a charter city and municipal corporation of the State of Cali fomi a ,hereinafter referred to as "City", and THE OMEGA GROUP, INC. a California corporation, hereinafter referred to as "Omega". A-2003-224 CrimeView@ Software Purchase Contract RECITALS 1. The City and Omega entered into Contract No A-200l-l59, dated October 10,2001 to create, update and install a Geographic Information System based crime analysis system, as well as provide training on the system (hereinafter referred to as "said Contract"). 2. Omega retained all necessary proprietary rights, patents and copyrights required to perform the services detai led in said Contract. 3. The City desires to purchase three (3) additional CrimeView@ software bundles for use by the Police Department. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. The term of this Agreement shall start July 1, 2003 and continue until terminated by either party. 2. Omega agrees to the following: A. Omega shall provide three additional Limited Use CrimeView@ software bundles as set forth in Exhibit A-I, attached hereto. B. Omega grants to Agency the non-exclusive license to install and utilize the CrimeView and Spatial Analyst software and associated services. C. Omega will provide training on the utilization of the software for four employees of the Santa Ana Police Department. D. The parties agree that the City may purchase one additional software bundle on the terms and conditions set forth in Exhibit A-I, at any time during the term of this Agreement. 3. For the software, associated licenses and training, City will pay Omega an amount not to exceed $25,000.00 (as further detailed in Exhibit A-I). Payment need not be made for work or products which fails to meet the standards of performance which may reasonably be expected of Omega by City. 4. Omega shall hold and keep harmless the City and all officers, employees, volunteers and agents thereoffrom damages, costs or expenses in law or equity that may at any time arise or be set up because of injuries to or death of persons or damage to, loss, or theft of property, including City's personnel and property, or from any claim that Omega's services or products infringe a proprietary right, patent or copyright arising by reason of, or in the course of Omega's or Omega's contractors, subcontractors, agents, employees, or other persons acting on their behalf, performance of this Agreement, or arising out of Omega's or Omega's contractors, subcontractors, agents, employees, or other persons acting on their behalf s intentional or negligent performance of this contract. Omega, at its own expense, cost and risk, shall defend, with counsel appointed STATE COMPENSATION INSURANCE I=UND -J... / ).)4 d-,OD ./ A~ IN REPLY REFER TO: APRIL 27, 2004 SANTA ANA POLICE DEPARTMENT ATTN BRIAN SHELDON 60 CIVIC CENTER PLAZA SANTA ANA CA 92702-6956 CERTIFICATE OF WORKERS' ~---------------------- COMPENSATION INSURANCE ---------------------- CANCELLATION NOTICE ------------------- RE: CERTIFICATE DATED OCTOBER 1, 2003 THE WORKERS' COMPENSATION INSURANCE POLICY FOR THE EMPLOYER NAMED BELOW HAS BEEN CANCELLED EFFECTIVE JUNE 1, 2004 AT 12:01 A.M. IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT THE EMPLOYER NAMED BELOW EMPLOYER: THE OMEGA GROUP, INC 5160 CARROLL CANYON RD FL 1 SAN DIEGO, CA 92121 POLICY 1302649-03 CUSTOMER SERVICE REPRESENTATIVE CUSTOMER SERVICE CENTER (877) 405-4545 ~e_~ 7 1275 Market Street . San Francisco. CA 94103-1410 Mailing Address: P.O. Box 420807' San Francisco, CA 94142-0807 selF 19102 ACORD," DATE IMMIOD/yYI 8/31/04 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. . ..COMPANIES ilI.FORDING CO"EIlAGE PRODUCER DRIVER ALLlANT INSURANCE 1620 FIFTH AVENUE SAN DIEGO, CA 92101 PRODUCER: CARMEN SCOPPETTUOlO The Omega Group Inc 5160 Carrol Canyon Road, 15t Fl. San Diego CA 92121-1775 .A - ~ 003 - 09-<-1 r----- , COMPANY I c~f'- ff""^","""^," CO""," COMPANY -SS"::P201(.q 13~04 RC(;~~ C INSURED COMPANY o THIS IS TO CERTIFY THAT 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 OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ------------- ------- -r- - "--'-'i~ I co I POLICY EFFECTIVE I POLICY EXPIRATION I l TR TYPE OF INSURANCE I POLICY NUMBER DATE (MM/DD/YYl ; DATE (MM/DO/YYl A L_~~_~ERAL LIABILITY I 35797495 i X : COMMERCIAL GENERAL LIABILITY ! LIMITS 8/27/04 8/27/05 GENERAL AGGREGATE 2000000 ClAIMS MADE X OCCUR '~PRODUC~S--~-~c:~Pi~-~GG PERSONAL & ADV INJURY ---------- --- EACH OCCURRENCE : FI~E _I?~~_~~~~~Y_ o~~_f~r~) ; MED EXP IAny on~ person) 2000000 OWNER'S & CONTRACTOR'S PROT 1000000 .1000000 1000000 10000 A 1--~_UTOM03lLE LIABILITY , , ANY AUTO r=--: ALL OWNED AUTOS 1___ j SCHEDULED AUTOS , X I HIRED AUTOS 1- x-I NON-OWNED AUTOS 74891759 HIRED CAR PHYS. DAMAGE: $500 COMP & COLL DEDUCTl8LES 8/27/04 8/27/05 COMBINED SINGLE LIMIT 1000000 BODILY INJURY IPerperson) ---.. BODilY INJURY (Peraccidsnt) ~GARAGE LIABILITY i --1 ANY AUTO 1------. ; PROPERTY DAMAG~ I I AUTO ONLY - EA ACCIDENT _____.~__n A EXCESS LIABILITY X UMOR~LLA FCRM 79822226 8/27/04 --t 8/27/05 OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EACH OCCURRENCE 1000000 1000000 THE PROf'I,I[Tl)Ri PARTNERS/EXECUTIVE I OFFICERS ARE A OTHER 'I PROFESSIONAL LIABILITY E & 0 INCL , tXCL I I__A_~_~REGATE I $ !----r:-!:~::~~~:N> Ol~ : t :~ ~ISE.ASE - ~_O_L~~Y LIMIT EL DISEASE - EA EMPLOYEE : an:ER THAN UMBRELLA FORM ! WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 35797495 8/27/04 8/27 /05 ! $1,000,000 CLAIMS MADE. $1,000,000 ANNUAL AGGREGATE $25,000 DEDUCTIBLE. DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECIAL ITEMS THE CITY, ITS OFFICERS, AGENTS, VOLUNTEERS AND EMPLOYEES ARE ADDITIONAL INSURED. SANTA ANA POLICE DEPARTMENT ATTN: BRIAN SHELDON 60 CIVIC CENTER PLAZA SANTA ANA, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPA);!\" WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIfICATE HOLDER NAMED TO THE LEFT, BUT fAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY THE COMPANY, ITS AGENTS OR REPRESENTATIVES. M so CERTHOLDER COPY STATE P.O. BOX 807, SAN FRANCISCO,CA 94142-0807 COMPENSATION INSURANCE FU N D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 10-01-2004 GROUP: POLICY NUMBER: 1302649-2004 CERTIFICATE 10: 29 CERTIFICATE EXPIRES: 10-01-2005 10-01-2004/10-01-2005 SANTA ANA POLICE DEPARTMENT ATTN 8RIAN SHELOON 60 CIVIC CENTER PLAZA SANTA ANA CA 92702-6956 SO This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer. We will also give you 30 days'advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term. or condition of any contract or other document with respect to which this certificate of insurance maybe issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms.exdusions and conditions of such policies. ~ ~~C &L AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUOING DEFENSE COSTS: $1 ,000, OQO. 00 PER OCCURRENCE. ENODRSEMENT #2065 ENTITLED CERTIFICATE HDLOERS' NOTICE EFFECTIVE 10-01-2004 IS ATTACHEO TO ANO FORMS A PART OF THIS POLICY. ~:V' EMPLOYER LEGAL NAME THE OMEGA GROUP, I NC 5160 CARROLL CANYON RO FL 1 SAN OIEGO CA 92121 THE OMEGA GROUP, INC IREV.3.03) PRINTED: 09/17/2004 .. . :' . . . ACORD - ,,~_. - I,," CERTIFICATE OF LIABILITY INSURANCE DAlE: tM"'UO'Y\'1 08,15'03 . THIS 'CER'nFICATE '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. COMPANIES AFFORDING COVERAGE PI10DIIC[H DRIVER ALlIANT INSURANCE 1620 FIFTH AVENUE SAN DIEGO, CA 92101 PRODUCER: CARMEN SCOPPETTUOlO COMPANY A FEDERAL INSURANCE COMPANY INSURED The Omega Group Inc 5160 Carrol Canyon Road, 15t Fl. San Diego CA 92121-1775 COMPANY B COMPANY C THIS IS TO CERTIFY THAT 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 OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POUCY EXPIRATION LIMITS LTR DATE IMM/DDIYYI DATE IMMIDOIYYI A GENERAL LIABILITY 35797495 8/27/03 8/27/04 GENERAL AGGREGATE 2000000 X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG . 2000000 CLAIMS MADE 0 OCCUR PERSONAL & ADV INJURY 1000000 OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE 1000000 FIRE DAMAGE (Anyone fire) 1000000 MED EXP (Anyone person) 10000 A AUTOMOBILE UABIUTY 74991759 8/27/03 8/27/04 COMBINED SINGLE LIMIT ANY AUTO HIRED CAR PHYS. 1000000 ALL OWNED AUTOS DAMAGE: BODILY INJURY SCHEDULED AUTOS $500 COMP & COLL (Per personl X HIRED AUTOS DEDUCTIBLES !.\ BOOIL Y INJURY X NON-OWNED AUTOS (Peraccidentl /~ PROPERTY DAMAGE GARAGE UABIUTY AUTO ONLY - EA ACCIDENT ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT . AGGREGATE . A EXCESS UABIUTY 79822226 8/27/03 8/27/04 EACH OCCURRENCE . 1000000 X UMBRELLA FORM AGGREGATE . 1000000 OTHER THAN UMBRELlA FORM WORKERS COMPENSATION AND EMPLOYERS' UABlUTY EL EACH ACCIDENT THE PROPRIETOR/ INCL EL DISEASE ~ POLICY LIMIT PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE A OTHER 35797495 8/27/03 8/27/04 PROFESSIONAL $1.000,000 CLAIMS MADE. LIABILITY E & 0 $1,000,000 ANNUAL AGGREGATE $25,000 DEDUCTI8LE. DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLfS/SPECIAL ITEMS THE CITY. ITS OFFICERS, AGENTS, VOLUNTEERS AND EMPLOYEES ARE ADDITIONAL INSURED. SANTA ANA POLICE DEPARTMENT ATTN: BRIAN SHELDON 60 CIVIC CENTER PLAZA SANTA ANA, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAfL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY / so CERTHOLDa\ COpy . !J!:\!!l;' '~$VIll"""'Ca .. \.....~ND.: ~Tff:~ttc>P.' WORKJ;RS' COMP-.sATION INSURANCE . ,'F," ",' "J - ,,' .' 'P:~.BOX'807, SAN FRANCISCO,CA 94142::--0a07 ",. _ _ .',' 'I<. _ -',' -'A: /-<'",' A- ;;).O(),3, .i~1 .:~.,lS~OA)E: 10-01-2003 " i -" " _-_--.;::,;_2[~~.:/; ~ ' , - ' , ~,- +>> d~_~;~~(~_ _ '. GROUP: POLICY NUMBER: 1302849-2003 i;;ERTIFICATE 10: 29 CERTIFI!';ATEEXPIRES: 10-01 -2004 10-01 c2003/10-01 "'004 $.AtlT A ANA POL t C):: . tl~N.Rt"'''NT SO AtTk.IlR1...80.SHE:t;nOttt . "(. ~O tt~~: tE,,1ER PLAZA. , SANTA ANA CA 92702-69~6 . \j~,-!:->'--;~ ' ',",' ':.: - ' ~;~--t~_ cer~--that we have tSS~.!I:f-a_Valid--Wcirker$' Com~ensation insurance POliCY",ii,. -~orm,,-~~rGved bY,':',itt:t.{,." J~:j{ffornia tri'sUranee Commissioner to tba/ ~er named below for the policy pedod indi~d. - ><- "- - ' ':(- ! ;-"'):,",,>'r- .-e.' :<< ,J ,', - - - - .. -",' ,-' - --~ ,'; This pdli~-_ii$:--~-_-:$iJbjt,~t, to",'~antellation by the Fund e~eept u~on 30 da~: ,dvance written notice to the employer. , 'c: /,';" ;<~ ; ",~{,'H "", " .,." " "'., I"~ ," , "',, '>, ,', '::,,:',_ ,:,,' ."",,,..,,,:,ijt also give yo~ sO dllys' advan<:e. n'!'lice .iiouid.thls policy be cancelied prior to Its llo';';'F'''i''Pir~';n. , '" " . ,,' ,>-;-,:"::''j" ,', ,::-':' '::,; , <-, - . ,_,,:' H ' , l'hIlt'~rtniCJte'9.t'ln.U(.""" ~~ ~ insurance policy and dollS not amell<j, eKiend or alter the coverage afforded br,ths pol,i6i">~*~ b~~i'1>4~ithstandi.ng anyr4tquir_,~~"term. or ccnditio~ qf IN;ly.~'9fl~aet or o~er:.doqum~.~",,,,,;:: wIth re.l\8Ct.:o whIch If>.. c"'tillcate of Insurance l'/'UW .!>e.,ssued or may. pertaIn. the'Sl"illIri!'lCs .ff<<~ by the '.' pol~Fj8S 'd~er'b.d henJtI1 IS subject to ~n, tn, terl'l'l$.\~e1~sIQns and condltl,ons of'~\pdJjcltls.', f~~~';'" " ;:"":', " .. '0' " " ~):: ,~' ,I A',,' .', ""'" : .""" /"'+;' ,. . ,^ ,.. , ;YL';;~;:v',f'3 ":,,,~,;, :,"':::, ,,:::{, Aufl.JO'RltE6 ~MATIVE ;,,-; A' .1J~C .&/2. " " .' ~MI'l..or~'su~!!'!:!'V UMIT .' "'\!"."" ;./ .-., ". .;. ';'~MIlNT^~ ENT1Tl.. . ~;~#'AA'I' Ql'1'l:l~~f'\lu : :::,:,<,'k\~'+', ':' H:,,:~::d:~,~{;{~1(" ' , 'Hi:'::,!:::' ,~' M:FENSE r.oSTs: . $ i, 000',000.00 PER dr.o.lR1i....cE. : ,'. -, ,', - TrFICATE HOLDERS' NdtrclrI$Ffl.<<CTIVE 10-01-2003 IS ATTACHED TO AND ", _, '. '\ ',"""'J" '." PRESIDENt "S' '; ~":\ , ,; ,~: "-;-; L1:l\AtJ~~ j THE ..OMEGA 100 . V '7. DRIVER ALLlANT INSURANCE 1620 FIFTH AVENUE SAN DIEGO, CA 92101 PRODUCER: CARMEN SCOPPETTUOlO DATE IMM/DDIYYI 8/31/04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A FEDERAL INSURANCE COMPANY INSURED The Omega Group Inc 5160 Carrol Canyon Road, 15t Fl. San Diego CA 92121-1775 A -;;u> 03 - old- <.f I COMPANY I B 1---------3EP?O.lOq~.-n-l ---;-, . COMPANY , ...... ..;i..~~" (Jl. RClt~,. C - , 1--- _._-~..~--_.- I COMPANY ! 0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TEAM 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 OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ---,------------- -.. ..__n____ -r---- - -------"---T--- ---------------,-- CO I TYPE OF INSURANCE ! POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION, LTR DATE (MM/OO/YY) DATE IMM/DDNY) LIMITS A ; GENERAL LIABILITY 35797495 x] COMMERCIAL GENERAL LIABILITY ['=-T:_] CLAIMS MADE i___)( J OCCUR I 1 OWNER'S & CONTRACTOR'S PROT ' ! -I 1-1-- ----- I A AUTOM08!lE LIABILITY 8/27/04 8/27/05 GENERAL AGGREGATE PRODUCTS - COMPtOP AGG PERSONAL & AOV INJURY EACH OCCURRENCE 2000000 2000000 1000000 1000000 1000000 10000 FIRE DAMAGE (Anyone lire) ----- ------------- MEa EXP IAr1Y Or1e person) ANY AUTO 74~91759 HIRED CAR PHYS. DAMAGE, $500 COMP & COLL DEDUCTlBLES 8/27/04 8/27/05 COMBINED SINGLE LIMIT 1000000 ALL OWNED AUTOS BOOIL Y INJURY IPerpersonJ I SCHE:DULED AUTOS !X HIRFD MHOS r -X-! NON-O'NNED AUTOS f- --! , i-- BODILY INJURY IPeraccident) PROPERTY DAMAGE , GARAGE LIABILITY ANY AUTO I A 'I' E_X.CESS LIABILITY , X I UMBRELLA FORM _-L~I-'F.R THAN UM6RELLA~.?RM ~_I______ I WORKERS COMPENSATION AND 1 I EMPLOYERS' LIABILITY, i THE PROF)IlICTOR/ I PARTNERS/EXECUTIVE' OFFICERS ARE; A OTHER 79822226 8/27/04 8/27/05 AUTO ONLY - EA ACCIDENT I OTHER THAN AUTO ONLY: L"-' -. EACH AC-CIDENT AGGREGATE $ EACH OCCURRENCE AGGREGATE 1000000 1000000 I_ _JT"Q~'1I~-I~~_ ___ Ol~- , EL EACH ACCIDENT $ I-E-~~;~~~--- ~~L1CY L1~I~ ----- ~ ------ ------,------ ! EL DISEASE - EA EMPLOYEE 35797495 8/27/04 8/27/05 PROFESSIONAL LIABILITY E & 0 $1,000,000 CLAIMS MADE. $1,000,000 ANNUAL AGGREGATE $25,000 DEDUCTIBLE. DES RIPTION OF OPERATIONS/LOCATIONS/VEHIClES/SPECIAlITEMS THE CITY, ITS OFFICERS, AGENTS, VOLUNTEERS AND EMPLOYEES ARE ADDITIONAL INSUREO. SANTA ANA POLICE DEPARTMENT ATTN: BRIAN SHELDON 60 CIVIC CENTER PLAZA SANTA ANA, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCelLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO 08L1GATION OR LIABILITY ITS AGENTS OR REPRESENTATIVES. AN . . CERTHOLDER COPY so STATE P.O. BOX 807, SAN FRANCISCO,CA !;!4142-0807 COMPENSATION INS U RAN C Ii; FU NO CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 10-01-2004 GROUP: POLICY NUMBER: 1302649"2004. CERTIFICATE 10: 29 CERTIFICATE EXPIRES: 10-01-2005 10-01-2004/10-01-2005 SANTA ANA POLICE DEPARTMENT ATTN BRIAN SHELOON 60 CIVIC CENTER PLAZA SANTA ANA CA 92]02-6956 SO This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer. We will also give you 30days'advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extender alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term. or condition of any contract orother dopument with respect to which this certificate of insurance maybe. issued or maypertain,the insurance afforded by the policies described herein is subject to all the terms, eXclusions and conditions of such policies. ~ ~~c ~ AUTHORIZED REPRESENT A TIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000.000.00 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2004 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. SEP29'0415:59 RCVO EMPLOYER ~ LEGAL NAME THE OMEGA GROUP, I NC 5160 CARROll CANYON RO Fl 1 SAN DIEGO CA 92121 T~E OMEGA GROUP, INC IIREV.3-031 PRINTED: 09/17/2004 PD408 .:lh....I.IIl.J1'JI:::lI~..:'.~.......:J.II=-:l....::I:I~1::I'.:f'ltf~ni:{'JlI~I' selF 1026" .-.-...',......-....'1ll-'-...,-'....-........;,-,... A CORDN PRODUCER 1111.1.II.I.lllllllillllll,.IIII.1 :~tt}?f{)f/~?:~:;;:;::; DATE (MM/DDIYYI .-. ':-J ............... 8/30105 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. COMPANIES AFFORDING COVERAGE ::" DRIVER AlL/ANT INSURANCE 1620 FIFTH AVENUE SAN DIEGO, CA 92101 PRODUCER: CARMEN SCOPPETTUOLO COMPANY A FEDERAL INSURANCE COMPANY INSURED The Omega Group Inc 5160 Carrol Canyon Road, 1 st Fl. San Diego CA 92121-1775 7:' ^_-7 "d 1'-1- AVV:.i-"",-.,Lj COMPANY B COMPANY C COMPANY o THIS IS TO CERTIFY THAT 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 OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 00 LTA Tii';: OF iiliSUAAi4(;E POUCY NUMBER POUCY EFFECTIVE POUCY EXPIRATION DATE IMMfDDlYY1 DATE IMMIDDIYYJ UMITS A GENERAL UABIUTY 35797495 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCUR OWNER'S & CONTRACTOR'S PROT 8/27105 8/27/06 GENERAL AGGREGATE PAODUCTS - COMP/OP AGG $ PERSONAL & ADV INJURY EACH OCCURRENCE FIRE DAMAGE (Anyone fire) MED EXP (Anyone person) 2000000 2000000 1000000 1000000 1000000 10000 A AUTOMOBILE UABILlTY ANY AUTO ~ ALL OWNED AUTOS 74991759 HIRED CAR PHYS. DAMAGE: $500 COMP & COLL, '-., DEDUCTIBL9l\l)l"?'U ,. 'D~~'~-~ ....---...t;>..",t,i '~ 8/27105 I; OR v1 8/27106 COMBINED SINGLE LIMIT 1000000 SCHEDULED AUTOS I X HIRED AUTOS X NON-QWNED AUTOS BODILY INJURY (Per person) ":.J- ',',.f>:;..ly BODILY INJURY (Per accident) GARAGE UABILlTY ANY AUTO PROPERTY DAMAGE A EXCESS UABIUTY ,X UMBRELLA FOAM 79822226 8/27105 8/27106 AUTO ONLY - EA ACCIDENT $ OTHEA THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EACH OCCURRENCE AGGREGATE 1000000 1000000 OTrll;;R T..Ai\i t..:MBHELi.A Fun...; WORKERS COMPENSATION AND EMPLOYERS' UASIUTY OTH- A THE PROPRIETORI PARTNERSIEXECUTIVE OFFICERS ARE; A OTHER PROFESSIONAL LIABILITY E & 0 35797495 8/27105 EL EACH ACCIDENT EL DISEASE - POLICY LIMIT EL DISEASE - EA EMPLOYEE lNCL EXCL 8/27/06 '10-DAY NOTICE FOR NONPAYMENT $1,000,000 CLAIMS MADE. $1,000,000 ANNUAL AGGREGATE $25,000 DEDUCTIBLE. DESCRIPTION OF OPERATlONSILOCATIONSNEHICLES/SPECIAL ITEMS THE CITY, ITS OFFICERS, AGENTS, VOLUNTEERS AND EMPLOYEES ARE ADDITIONAL INSURED. SANTA ANA POLICE DEPARTMENT ATTN: BRIAN SHELDON 60 CIVIC CENTER PLAZA SANTA ANA, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~ DAYS WAlTTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR UABIUTY THE COMPANY. iTS AGENTS OR REPRESENTATIVES. ACORD," PRODUCER DATE \MMIDDNY) 8/30/05 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. COMPANIES AFFORDING COVERAGE DRIVER ALLlANT INSURANCE 1620 FIFTH AVENUE SAN DIEGO, CA 92101 PRODUCER: CARMEN SCOPPETTUOLO INSURED COMPANY A FEDERAL INSURANCE COMPANY COMPANY B The Omega Group Inc 5160 Carrol Canyon Road, 151 FI. San Diego CA 92121-1775 COMPANY C COMPANY D THIS IS TO CERTIFY THAT 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 DESCAIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO lTR, TYPE OF INSURANCE A GENERAL UABllITY X COMMERCIAL GENERAL LIABILITY ITJ CLAIMS MADE 0 OCCUR H OWNER'S & CONTRACTOR'S PROT '---I-~-~ A AUTOMOBILE LIABILITY B ANY AUTO ; All OWNED AUTOS ~ SCHEDULED AUTOS X HIRED AUTOS X NON-OWNED AUTOS GARAGE LIABILITY I ANY AUTO ,-, POLICY NUMBER POLICY EFFECTIVE POLICY fXPIRATION LIMITS (lATF IMM/DDtvYI OATF. (MM/DnrvYJ 35797495 8/27/05 8/27/06 GENERAL AGGREGATE PRODUCTS - COMP/OP AGG , PERSONAL & ADV INJURY EACH OCCURRENCE FIRE DAMAGE (Anyone fire) MED EX? ,Anyone person; , 74991759 8/27/05 8/27/06 COMBINED SINGLE LIMIT HIRED CAR PHYS. DAMAGE: BODilY INJURY $500 COMP & COLL (Per person) DEDUCTI8LES BODILY INJURY (peraccidentl PROPERTY DAMAGE AUTO ONlY - fA ACClOENT OTHER THAN AUTO ONLY: EACH ACCIDENT , AGGREGATE , 79822226 8/27/05 8/27/06 EACH OCCURRENCE AGGREGATE A i EXCESS L1ABIUTY 1000000 X UMBREllA FORM 1000000 OTHER THAN UMBRELLA FORM I WOflj(ER~ COMPENSATiON AND EMPLOYERS' LIABILITY THE PROPRIETOR/ ~ INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCl A OTHER I PROFESSIONAL : LIABILITY E & 0 35797495 81 o&-f~ "' O-DA Y NOTICE FOR NONPAYMENT DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAlITEMS ADDITIONAL INSURED ENDORSEMENT ATTACHED. '1 O-DA Y CANCELLATION NOTICE FOR NONPAYMENT OF PREMIUM. CITY OF SANTA ANA, ITS OFFICERS, AGENTS, VOLUNTEERS & EMPLOYEES, POBOX 1988 SANTA ANA, CA 92702-1988 !l.QORtl2!i:J;UI951 . ........::;~~(\.... . ..--..,..--...,...."..,--...--......,'...','..,...,','....,','.','.','..--'..--''',.','.'..,'' 2000000 2000000 1000000 lGGGGOG 1000000 1GGOO 1000000 ,EGA TE ) BEFORE THE VOR TO MAIL I TO THE LEFT, II OR L1ABlllTY RESENTATIVES. . ..IilACPIlOCPllPOl'iAttOI\l.19S11 1 . PRODUCER ......."............ A CORaM m~'ml.II^llle:uIIBII:III:i:lm:liIIIIIEH:.i...i.i.i.....::...:.......:.................:.............:.:............. DATE ~~~~~g~Y) . .. . .....~:;;;;;~~::::;::::::S~[lf:.:/:...J;:...::::..:.:..)r!l:::-...:::::...:.:.:,;:;::;::....:....:::-...::;:;::::::;....:.:.::-.-::..::::::.:.:::-:.;-:-:::.>:.:.~.;.~.:.::~:~-:):~:~::.:.~:~:i~:~::::::):: :.:::::.~.:.::::::::;:;:::/:)::.:-::::::::::::;::):::::::::::::::::::::::::;:;:~:::::::::::~::::::.:.:.:.:.:.: : ... . . THIS GERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR AL TEF: THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE DRIVER ALLlANT INSURANCE 1620 FIFTH AVENUE SAN DIEGO, CA 92101 PRODUCER: CARMEN SCOPPETTUOLO COMPANY A FEDERAL INSURANCE COMPANY INSURED The Omega Group Inc 51 60 Carrol Canyon Road, 1 5t FI. San Diego CA 92121-1775 A - ~CJJ 3 - r:JttfJ..LJ -(J I COMPANY B COMPANY C THIS IS TO CERTIFY THAT 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 OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN FEDUCED BY PAID CLAIMS. co ! LTR TvrE cr :r~SL:R;"NC[ POLiCY rJUiviS[R POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/Dt'IYYI DATE (MM/DDIYYI UlvHTS A GENERAL LIABILITY 35797495 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCUR OWNER'S & CONTRACTOR'S PROT 8/27/06 8/27/07 GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ PERSONAL & ADV INJURY EACH OCCURRENCE 2000000 2000000 1000000 1000000 1000000 10000 FIRE DAMAGE (Anyone firel MED EXP (Anyone personl A RAUTDMOBILE LIABILITY ANY AUTO ~ -1 ALL OWNED AUTOS I I SCHEDULED AUTOS ~ HIRED AUTOS X NON-OWNED AUTOS 74991759 HIRED CAR PHYS. DAMAGE: $500 COMP & COLL DEDUCTIBLES 8/27/06 8/27/07 COMBINED SINGLE LIMIT 1000000 BODILY INJURY (Per personl BODILY INJURY (Per accident) PROPERTY DAMAGE A ~ESS LIABILITY ~ UMBRELLA FORM t 0 "HtH I HAN UMtlR::LLA I-URM , WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 8/27/06 8/27/07 AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EACH OCCURRENCE AGGREGATE GARAGE LIABILITY ANY AUTO 79822226 1000000 1000000 OTH- ER THE PROPRIETOR/ PARTNERS/EXECUTIVE OFFICERS ARE: A OTHER PROFESSIONAL LIABILITY E & 0 RETRO DATE 8/2/02 INCL EXCL EL DISEASE - POLICY LIMIT EL DISEASE - EA EMPLOYEE * 1 O-DA Y NOTICE FOR NONPAYMENT $1,000,000 CLAIMS MADE. $1,000,000 ANNUAL AGGREGATE $25,000 DEDUCTIBLE. qj ~ lT1 o en o (..0 .. W -.J ~ 35797495 8/27/06 8/27/07 DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECIAL ITEMS THE CITY, ITS OFFICERS, AGENTS, VOLUNTEERS AND EMPLOYEES ARE ADDITIONAL INSURED. A CORD_ CERTIFICA TE OF LIABILITY INSURANCE OP 10 1~ DATE (MMlDD/YYY'() THEOM-l 11/19/07 PRODUCER " THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION , ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Alliant Insurance Services Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1620 Fifth Avenue Al TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. San Diego CA 92101 Phone: 619-238-1828 Fax: 619-699-2101 INSURERS AFFORDING COVERAGE NAIC# INSURED A- ~(t:)3 ..~;XJ..f INSURER A Federal Insurance Company The omega Group Inc A -0200 J - ~J. "I -0 I INSURER B' Ma*,a ~puhn INSURER C' 51 0 Carroll can!on Rd 1St Fl. INSURER D San Diego CA 921 1-1775 INSURER E COVERAGES THE POLICIES OF INSURMCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTMDING 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 OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTR NSRC TYPE OF INSURANCE POLICY NUMBER DATE (MMlDDIYY) '~kt1;\MMI6DrYv) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 ~ A X X COMMERCIAL GENERAL LIABILITY 35797495 08/27/07 08/27/08 UJ<IW\c,c $ 1,000,000 PREMISES lEa oecurence) I---- =:J CLAIMS MIlDE ~ OCCUR c-- MED EXP (Anyone person) $ 10,000 PERSONAL & ADV INJURY $1,000,000 I-- GENERAL AGGREGATE $2,000,000 -""" GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP N3G $ 2,000,000 I n PRO- nLOC POLICY JECT AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT - $1,000,000 A ANY AUTO 74991759 08/27/07 08/27/08 (Ea accidentl - ALL O\IIJNED AUTOS BODIL Y INJURY - $ SCHEDULED AUTOS (per person) - ~ HIRED AUTOS BODIL Y INJURY $ X NON OWNED AUTOS (per aCCident) - ----' - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ H ANY AUTO OTHER THAN EAACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000 A o OCCUR D CLAIMS MADE 79822226 08/27/07 08/27/08 AGGREGATE $ 1,000,000 $ ~ DEDUCTIBLE $ , RETENTION $ < I . .-..,-- I ITORY liMITS I Iv~;r WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ If yes, d~saib61 under SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $ OTHER A, PROF. LIAB. E&O 35797495 08/27/07 08/27/08 AGGREGATE 1000000 \ CLAIMS MADE DEDUCT. 25000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS The City, its officers, agents, volunteers and employees are additional insured under the General Liability as required by written contract as ~ respects to operations of the Named Insured. *10 days notice for non-payment. SANTA-1 CANCELLATION 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 REPRESENTATIVES. A 0 CERTIFICATE HOLDER Santa Ana Police Department 60 Civic Center Plaza Santa Ana CA 92702 @ACORDCORPORATION1988 ACORD 25 (2001/08) 'J (" ?" .~ . IMPORT ANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) ~ AcoRV_ CERTIFICATE OF LIABILITY INSURANCE ~,vlo vim, D'"'T^~'`'M~DDnvrYl A1liant Insurance servi cea Ina 701 8 Street, 6th Floor San Diego CA 92101 Phone: 619-238-1628 Fax: 619-649-4731 wsuR eD ._..__.. ......._....____._..___.__. _... The Oanegga Group Inc Vance SEewart 5160 Carroll Canyon Rd 1St F1 San Diego CA 92121-1775 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ANY REOUIREMENT. TERM OR CONDITION OF ANY CONT MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN R _____.._._.._~_.. _.____POLI< _TR NSR TYPE OF INSVRANCE i GENERAL LIABILITY A ' ~{ X ~GOMMERCIAL C' IJFRAl. .i4DILITY ',' 3~j']97491j L _. „ ..,, ..I CLAIMS MADE - ~X _I OCCUR •.. _ i i I I rvwvreu AncavE roR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSVED OR IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF S VCH 09/27/09 1TE MIDOKY LIMITS EACH OCCURRENCE ~ S 1 , 000 , OOO AlOIRGE-fDTtE'FTTEU •.__ - ...... ___.._ O9/27/10 iPREMISES (Ea oaure sl _s 1,000, 000 _- _.._. MED ExP (Any one Person) _ 15 1 O ~ O.O O _,__,., 1 PERSONAL A ADV INJURY E , OOO , OOO __.. ...... OENERAI..AOC+REOATE S 2 OOO OOO GEN'L AGGREGATE LIMIT APPLIES PER ' + POLICY ~- PRO- r~ ,.. PRODUCTS GOMP/OP AGG S 2 000 , 000 - LOC ____ AUTOMOBILE LIABILITY t A ' ANY AUTO 74991759 ~ ~ COMBINED SINGL M(T~ 09J27/10 I (Ea 0OC d6n1 ~ s 1.p000,000 08/27/09 f ALL OWNED AUTOS I ~ I -'- ~T "'^'~ i --~~.. - BODILY INJURY I-E] ~ SC-IEDULEO AUTOS (pa ~,acn) .I~ S ~ ~ X HIR F.O AUTt~', 11 I-]_ I-~ ~ I ][ NON OWNFD AJTUS ~ ._L,, BODILY INJURY ~ 5 ~ ~ (Pe ccidentj [~~ -- I ' ~~~~~ PROPF_RTY DAMAbF.. 8 I I (Par accltlan0 m GARAGE LIABILITY ~ ... ' AUTO ONLY EA IiCCIDCNT E ANY AVTp '. ~ _ __... i ..___ - ~ ~E{~yCC 6 N L i ___ _..... ! .AUTO ONLY _RGG,, $Q E%CESS/UMBRELLA LIABILITY i FA('H OCCURRENCE~~' S OOO , DOO A $ xcL.R _. Ct.A1M5 MADF 79822226 08/27/09 '.. OBJ27/10 4AGGREGATE s 1 OOO,OOp . DEDUCTIBLE -, -._ __._ _ • _..... I-__,____-_ _-.,.-5 __ ,_, ..._.__._ .._.. I RFTF_NTKJIV S 'S WORKERS COMPENSATON AND ~ _ _. EMPLOYERS LIABILITY I .__.y?ORY LIMBS ~ ER {._.-._..___. _.. I ANY PROPRIETORfPARTNER/E%ECUTIVE i E L EACH ACCIDENT S I OFFICERrtNEMBER EXCLUDED? i ~ __ ........_.... __..... 1 li yyeeee tlaacribe under i f E.L. UISEAS- EA EMPLOYEE S ....... SPECIAL PROVISIONS below ~ EL. DISEASE -POLICY LIMIT~- OTHER i 1 A PROF. LIAB. E60 35797495 08/27/09 08/27/lO AGGREGATE 1000000 CLAIM3 MADE' DEDUCT. 25000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES / E%CLU310N9 ADDED BY ENDORSEMENT /SPECIAL PROVISIONS The City, its officers, agents, volun tears and employ®ea are additional insured under the General Liability as required by written contract as respects to operations of the Named Insured. X10 days notice For non-payment. SANTA-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE E%PIRATM DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 90 SMALL Santa Ana Police Department 6O C1 ViC Center Plaza IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSVRER, ITS AGENTS OR Santa An8 CA 92702 REPRESENTATIVEB, AUTHORRED REPRESENTATNE ACORD 25 (2001106) ®ACORD CORPORATION APPROVED A O FORM INSURERS AFFORDING COVERAGE NAIC At ISSUED TO THE INSVRED RACT OR OTHER DOCUM IES DESCRIBED HEREIN EDUCED BY PAID CLAIMS. 96t IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policles may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.