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<br />
<br />A.êaRIL
<br />
<br />Client#: 600~-'-
<br />
<br />'HABRAN
<br />
<br />CERTIFICAl t: OF LIABILITY INSURANCE
<br />
<br />I OATE(MM/OD/YY)
<br />10/18/04
<br />
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />
<br />INSURERS AFFORDING COVERAGE
<br />
<br />IODUCEA
<br />ealey, Renton & Associates
<br />. O. Box 10550
<br />anta Ana, CA 92711-0550
<br />14427-6810
<br />
<br />3URED
<br />
<br />Michael Brandman Associates
<br />220 Commerce Center #200
<br />Irvine, CA 92602
<br />
<br />~INSURER A: United States Fidelity ~ G~~~anty -
<br />' INSURER B:St. Paul Fire & Marine Ins. CO.
<br />~_SURER c:Ameri<:~I2...~lJ!~~~~~le- !ns. CO.
<br />INSURER D:Great American Assurance Co.
<br />----'-~----- -- . -.
<br />
<br />------------- -
<br />
<br />-----_._~ -----
<br />
<br />INSURER E:
<br />
<br />JVERAGES
<br />HE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
<br />NY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />lAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
<br />'OLICIES. AGGREGATE UMfTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS-
<br />'~ TYPE OF INSURANCE POLICY NUMBER ¡ POÄ!fY ~~¡CJ)~E PO~¥Y~~~RAJJ~N- LIMITS
<br />~N~~AL LIABILITY BK01565071 ! 11/15/03 : 11/15/04 ~!:~~_<?CC_~Re:.N_CE- - sl.,OO9..999
<br />~MERCIAL GENERAL LIABILITY - FIRE Q~MAGE (~~')'_~ne II~Ls1 00,000
<br />Ll.-.J CLAIMS MAD~ X , OCCUR ME D EXP (Anyone person) s10,OOO
<br />U ~~_~~NAL !~~",!~JU.Ry_i1..000,OQQ... -----
<br />U ~~p~~.RA~~~<!Re:~A_~E, -.ß,j_OOo.,QQQ-----
<br />lGEN1..AGGRE,IGATjLIMITAPPLnIESPER: ; : PR~DUC!.~CO~!O~~~~. s2,OOO,9.Q!! . -----
<br />n POLICY' PRO, LOC '
<br />, AUTOMOBILE UABILITY :BA01574185
<br />
<br />111/15/03
<br />I
<br />I
<br />
<br />I
<br />¡
<br />I
<br />i
<br />, i
<br />
<br />¡ 11/15/04
<br />
<br />, COMBINED SINGLE LIMIT S1 000 000
<br />(E.. "ccIOenl) , ,
<br />
<br />X ANY AUTO
<br />L ALL OWNED AUTOS
<br />i SCHEDULED AUTOS
<br />r X HIRED AUTOS
<br />r X NON.OWNED AUTOS
<br />~--l
<br />H
<br />
<br />~AAGE LIABILITY
<br />i I ANY AUTO
<br />n
<br />
<br />...-. ._-- 0+ -- ---. .-- ---. .
<br />
<br />. -.----.---
<br />
<br />....-----
<br />
<br />I BODIL Y INJURY
<br />, (Per person)
<br />
<br />,
<br />, BODIL Y INJURY
<br />, (Per ..cc,oenl)
<br />
<br />s
<br />
<br />~XCESS LIABILITY
<br />I , '
<br />, OCCUR 0 CLAIMS MADE,
<br />
<br />
<br />~ DEDUCTIBLE
<br />: I RETENTION S :
<br />
<br />
<br />PROPERTY DAMAGE
<br />(Per "ccloent)
<br />
<br />'s
<br />
<br />,AU~O ()N~V.,~A~C?CIOENT_S._.
<br />
<br />OTHER THAN
<br />AUTO ONL Y:
<br />
<br />EA ACC S
<br />AGG S
<br />
<br />EACH OCCURRENCE
<br />, AGGREGATE
<br />
<br />-- ..--------- ----
<br />,
<br />
<br />2___,__--
<br />
<br />WORXERS COMPENSATION AND
<br />EMPLOYERS'LIABILITY
<br />
<br />18H1WZP80917294
<br />
<br />11/15/03
<br />
<br />111/15/04
<br />ì
<br />
<br />L_- ---- -------- ,-~-- -_..:..S
<br />s
<br />, X I WC STATU.DTH.
<br />~8YJ.IMIIS_-----ER '
<br />,E,L, EACH ACCIDENT' s1,OOO,000
<br />,
<br />i E.L,OISEASE.EAEMPLOYEE 51,000,000
<br />¡ E.L. DISEASE.POLlCY LIMIT s1,OOO,OOO
<br />! $1,000,000 per claim
<br />! $2,000,000 ann I aggr.
<br />
<br />i OTHER Professional
<br />'liability
<br />I
<br />
<br />EDN5656247
<br />
<br />11/15/03
<br />
<br />i
<br />i 11/15/04
<br />1
<br />
<br />SCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
<br />': All Operations as pertains to named insured.
<br />e City of Santa Ana, Its officers, employees, agents, volunteers and
<br />Jresentatives are Additional Insured as respects to General Liability.
<br />
<br />RTlFICATE HOLDER
<br />
<br />, ADomoNALlNSURED: INSl.'RER LETTER:
<br />
<br />CANCELLATION
<br />
<br />
<br />City of Santa Ana
<br />Public Works Agency
<br />AUn: Taig Higgins
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />
<br />SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATlON
<br />
<br />DATETHEREOF.THE ISSUING INSURER WIL~~~JCJ MAIL30_- DAYS WRITTEN
<br />
<br />NOTlCE TO THE CERTlFICATE HOLDERNAMED TO THE LEFT. B~JOI a:.9!JlÞCIOC.XX
<br />
<br />~~J09{)ONOAouo:xnJ:!t]ll;)00 (:IIX,~2XXi ( t~J:~X~2:1tX
<br />
<br />ED.~ms,
<br />AUTHORIZE D REPRESENTATIVE
<br />
<br />:ORD 25-S (7/97)1
<br />
<br />of 1
<br />
<br />#M95248
<br />
<br />
<br />TMN
<br />
<br />~ ACORD CORPORATION 1988
<br />
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