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<br />,...:-...
<br />'A CORO,. CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
<br />12/4/03
<br />PRODUCER THIS CERTiFICATE is ISSUED AS A MATTER OF iNFORMATION
<br />Frenkel of California ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />Environmental Risk Services Group HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
<br />725 S" Figueroa Street, Ste. 2200
<br />Los Angeles CA 90017 INSURERS AFFORDING COVERAGE NAIC#
<br />INSURED INSURER A Gulf Underwriters Ins CO
<br /> INSURERB, Lumbermans Mutual 190
<br />National Econ Corporation INSURERC State Compensation Ins Fund 35076
<br />730 El Camino Real INSURER 0
<br />Tustin CA 92780 tJ - õ/oo3 -- /51 INSURERE'
<br />
<br />COVERAGES
<br />
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED"
<br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL
<br />THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
<br />'~,s: N~~" POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
<br />
<br />AUTOONLY.EAACCIDENT $
<br />EAACC $
<br />AGG $
<br />$4,000,000
<br />,4,000,000
<br />$
<br />,
<br />,
<br />
<br />A X ~NERALLIABILITY GU7119999
<br />~~MMERCIALGENERALLIABILITY
<br />,----.-J CLAIMS MADE ~ OCCUR
<br />
<br />-
<br />
<br />7/1/03
<br />
<br />7/1/04
<br />
<br />EACH OCCURRENCE
<br />A
<br />PREMISES E""""o,,
<br />MED EXP (Aoy '" P""oJ
<br />
<br />PERSONAL & ADV INJURY
<br />GENERAL AGGREGATE
<br />
<br />A
<br />B
<br />
<br />~'LAGGRE~ELlMITAP~SPER'
<br />I X I POLICY I I ~¡;.pT I I LOC
<br />~TOMOBILELIABILITY
<br />I-- ANY AUTO
<br />I-- ALLOWNEDAUTOS
<br />Ë- SCHEDULED AUTOS
<br />~ HIRED AUTOS
<br />~ NON-OWNED AUTOS
<br />
<br />-
<br />
<br />PRODUCTS. COM PlOP AGG
<br />
<br />7/1/04
<br />4/8/04
<br />
<br />7/1/03
<br />4/8/03
<br />
<br />GU71l9999
<br />E3G056620-00
<br />
<br />COMBINED SINGLE LIMIT
<br />(E""id,"l)
<br />
<br />BOOIL Y INJURY
<br />(P"p""')
<br />
<br />BODILY INJURY
<br />(P""dd,",)
<br />
<br />DE
<br />
<br />-3 {J3
<br />
<br />PROPERTY DAMAGE
<br />(P"""d,"l)
<br />
<br />-"lRAGE LIABILITY
<br />I ANY AUTO
<br />
<br />OTHERTHAN
<br />AUTO ONLY,
<br />
<br />-¥lESs/UMBRELLA LIABILITY
<br />~ OCCUR D CLAIMSMAOE
<br />
<br />I DEDUCTIBLE
<br />X1RETENTION ,$10,000
<br />C WORKERS COMPENSATION AND
<br />EMPLOYERS' LIABILITY
<br />
<br />7/1/03
<br />
<br />EACH OCCURRENCE
<br />AGGREGATE
<br />
<br />7/1/04
<br />
<br />A
<br />
<br />GU7120000
<br />
<br />,1,000,000
<br />,50,000
<br />, 5,000
<br />$1,000,000
<br />,2,000,000
<br />$2,000,000
<br />
<br />$1,000,000
<br />
<br />$
<br />
<br />ANY PROPRIETOR/PARTNERlEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED?
<br />Ify""d","",d"
<br />SPECIAL PROVISIONS b,low
<br />
<br />A ~T:;~essionaILiab
<br />Claims Made Form
<br />
<br />x I T"/,~~T~T,¥;, I I oJ!;"
<br />E.LEACHACCIDENT ,1,000,000
<br />E.L DISEASE-EAEMPLOYEE $ 1, 000, 000
<br />E,L,DISEASE.POLICYLlM'T S 1,000,000
<br />Each Claim Included
<br />Aggregate Included
<br />
<br />12/1/03
<br />
<br />12/1/04
<br />
<br />1663649-02
<br />
<br />7/1/03
<br />
<br />7/1/04
<br />
<br />GU71l9999
<br />
<br />DESCRIPTION OF OPERATIONS J LOCATIONS IVEHICLES I EXCLUs/ONS ADOED BY ENDORSEMENT I SPECIAL PROVISIONS
<br />City of Santa Ana, its officers, agents, employees and volunteers are added as Additional Insureds to the General
<br />Liability but only as respects all covered operations of the Named Insured" Insurance is Primary Non-Contributory"
<br />
<br />
<br />,:/
<br />, /, ~
<br />
<br />II?
<br />(
<br />
<br />CERTIFICATE HOLDER
<br />City of Santa Ana
<br />
<br />Attn, Arabela Saldivar
<br />20 Civic Center Plaza/PO Box 1988
<br />
<br />CANCELLATION
<br />
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
<br />BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER
<br />WILL ~ MAIL 30 DAYS ~
<br />~ WRITTEN NOTICE TO THE CERTIFICATE
<br />HOLDER NAMED TO THE LEFT, ~
<br />
<br />Santa Ana CA 92702
<br />
<br />AUTHORIZED REPRESENTATIVE
<br />
<br />ACORD 25 (2001/08)
<br />
<br />l"""~'"
<br />@ACORDCORPORATlON1988
<br />
<br />,'1i.R <r- !
<br />
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