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<br />. <br /> <br />~.. . CERTIFICATE OF LIABILITY INSURANCl;pri:!~ S9 DATE (MMIODIVY) <br />ACORD. <br />. . 09/01/03 <br />PRODuceR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Wood-Gutmann Insurance Brokers ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />License #0679263 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />14192 Franklin Ave., Suite 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Tustin CA 92780-7044 INSURERS AFFORDING COVERAGE <br />Phone:714-505-7000 Fax:714-573-1770 <br />INSURED A -~oD3 -/72/3 INSURER A. St. Paul Fire and Marine <br /> INSURER B Everest National Insurance <br />JðL & Associates Inc. INSURER C Continental Casual tv <br /> 1 Corporate Park, Ste 310 INSURER D <br /> Irvine CA 92606 <br /> INSURER E <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABove FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN. THE INSURANCE AFFORCED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> <br />l.1'R' TYPE OF INSURANCE POUCY NUMSER DAte MMiDDNY DATE MMlDQIYY LIMITS <br /> GENERAL UABlUTY EACH OCCURRENCE .1,000,000 <br />A X COMMERCIAL GENERAL LIABILITY BK0154543 09/01/03 09/01/04 FIRE DAMAGE (Anyone fire) . 100,000 <br /> CLAIMS MADE ~ OCCUR MED EXP (Anyone person) .' 5,000 <br /> PERSONAL & ADV INJURY .1,000,000 <br /> GENERAL AGGREGATE . 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPt..IES PER. ' PRODUCTS. COMP/O? AGG . 2,000,000 <br /> POLICY n ~~8T cae <br /> AUTOMOBILE LIABILITY ' <br /> I COMBINED SINGLE LIMIT .1,000,000 <br />A ANY AUTO BK0154543 09/01/03 09/01/04 (Eaawdent) <br /> AlL OWNED AUTOS BODILY INJURY <br /> . <br /> SCHEDULED AUTOS (Per person) <br /> X HIRED AUTOS SOOlL Y INJURY <br /> X (Per accid8l1t) I' <br /> NON-OWNED AUTOS <br /> PROPERTY DAMAGE . <br /> (P8f'accident) <br /> GARAGE UABILITY AUTO ONLY. EA ACCIDENT . <br /> ANY AUTO OTHER THAN EAACC . <br /> AUTO ONLY. AGG . <br /> EXCESS UABIUT'Y EACH OCCURRENCE . 1,000,000 <br />A X OCCUR 0 CLAIMS MADE SK0154543 09/01/03 09/01/04 AGGREGATE . 1,000,000 <br /> . <br /> DEDUCTIBLE . <br /> RETENTION . . <br /> \\fORKERS COMPENSATION AND <br />B EMPLOYERS' LIABlUTY 3900031544-031 05/01/03 05/01/04 000,000 <br /> 000,000 <br /> .1 000 000 <br /> OTHER <br />C Professional Liab MCA114132312 09/01/03 09/01/04 $5,000,000 <br /> <br /> <br />DESCRIPTION OF OPERATIONS/LOCATlON$NEHICLESfEXCLUSlØNS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />*10 Days notice of cancellation for non payment of premium. Certi#ï-pf'YfoVE' . <br />holder is named as additional insured per attached BF21810401 along with D AS TO <br />Primary wordign, as their interest may appear. XXX <br /> <br />FORM <br /> <br />L <br /> <br /> <br />SANT040 <br /> <br />CANCELLATION orncy <br />SHOULD A14Y OF THE ABOVE DESCRIBED POLICIES BE C,t.NCELLED BEFORE THE! EXPIRATION <br />DATE THEREOF, THe ISSUING INSURER ~'..~ - -- ._" .'" M,t.IL ...3.Q.!. DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BtfT r IUfRiTi I. II J,.~.... <br /> <br />CERTIFICATE HOLDER <br /> <br />N ADDfTIONAL INSURED; INSURER LETTER: <br /> <br />City of Santa Ana <br />Public Works Agency <br />Attn: Ruth Smith <br />20 Civic Center Plaza, M43 <br />Santa Ana CA 92701 <br /> <br />.IIi1PI1- .,.... nAIIr.!o""""''' 9A' L a._ff' !fI' IJ IIIIJI UI'iH' Till flJ!_..!.., .r8 .&21..- 4.. <br />~il'nli.&tI--"""ca <br /> <br />AUTHORIZED REPRESENTATIVE <br /> <br />ACORD 25-5 (7/97) <br /> <br />-.ð-r <br />iC) ACORD CORPORATION 1988 <br /> <br />