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<br />. <br /> <br />SANJOAQ-02 <br /> <br />AYDA <br /> <br />. I DATE (MMIDDNYYY) <br />A CORp. ,eERTIFICATE OF LIABILITY INSURANCE 8/15/2005 <br />PRODUCER (559) 432-0222 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />DiBuduo & DeFend is Insurance Brokers. LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR <br />License #OE02096 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />P.O. Box 5479 <br />Fresno. CA 93755-5479 . INSURERS AFFORDING COVERAGE ~ NAIC # <br />-- ----- ------ ---- ------ ---------- . --- ____no" ------ ~--- -- -- -.------ <br />INSURED San Joaquin Chemicals Inc. ;.J- 7,003'-0,s-'/ 0~SURER A: Hudson Insurance Company <br /> ----- .---------... ..' -------- --. ,------ ------.---.....,.--.- <br /> 4684 East Hedges Ave INSURER B: St~e CO~P_~':1s~!~~n Ins~~~_r:'~El'J:un~__ _ . <br /> Fresno. CA 93703-0000 IV -,;ltJ<'J.3 -o,s--I-oJ .. -- <br /> \ IN_~~ER C ____ _ <br /> ~:~:::-~~- ------ -- ----- ----- --- .-- <br /> . ---- .. ------- <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 AFFORDED 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 />INSR~Db'L <br />LTR <br /> <br />-POLICY' EFFECTIVE <br />/0 NY <br /> <br />POLICY-EXPIRATION <br />M /DNY <br /> <br />LIMITS <br /> <br />EACH OCCURRENCE I $ <br />, DAMAGE TO REJiJTI:D --- '~ <br />_E'BEMI.SE:9 (Ea o.ccuren~_. . .5. <br /> <br />ME~~~P(Any on~_~rson) _?_ <br /> <br />PERSONAL & ADV INJURY . $ <br />---~-_...- <br /> <br />POLICY NUMBER <br /> <br />A I X <br /> <br />GENERAL LIABILITY <br />r'X-;: COMMERCIAL GENERAL LIABILITY !CHEPL00099 <br />'---.-, ; CLAIMS MADE I_X_..... I OCCUR' <br />~-~r <br /> <br />GENERAL AGGREGATE i $ <br />----- - ------+-----.- <br /> <br />4/30/2005 <br /> <br />4/30/2006 <br /> <br />GEN'L AGGREGATE LIMIT APPLIES PER- <br />i POLICY I j~8T LOC <br /> <br />A <br /> <br />'I' ;~rOA:~B~~~~IABILlTY <br /> <br />X ALL OWNED AUTOS <br />x.... SCHEDULED AUTOS <br />X HIRED AUTOS <br />, i NON-OWNED AUTOS <br /> <br />CHEPA000100 <br /> <br />4/30/2005 <br /> <br />GARAGE LIABILITY <br />I ANY AUTO <br />I <br /> <br />A <br /> <br />, EXCESS/UMBRELLA LIABILITY <br />~I _~ OCCUR CLAIMS MADE ICHEPU000101 <br /> <br />DEDUCTIBLE I <br />~ RETE~!~~~__':____ !O'OOlO -- --- <br />WORKERS COMPENSATION AND <br />EMPLOYERS'L1ABILlTY 168187505 <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />If yes desCribe under <br />SPECIAL PROVISIONS below I <br />OTHER <br /> <br /> <br />4/30/2005 <br /> <br />6/29/2005 <br /> <br />6/29/2006 <br /> <br /> <br />B <br /> <br />EL. DISEASE - EA EMPLOYEE <br /> <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />Cancellation: Ten day notice of cancellation for non-payment of premium <br /> <br />Laura Stit ,heedy <br />Assistant C'y Attorney <br /> <br /> <br />1.000.00 <br />100.00 <br />5.00 <br />1.000.00 <br />2.000.00 <br />2.000.00 <br /> <br />1.000.00 <br /> <br />2.000.00 <br />2.000.00 <br /> <br />1.000.00 <br />1.000.00 <br />1.000.00 <br /> <br /> <br />City of Santa Ana, its officers, employees, agents, volunteers and respresentatives are named as additonal insureds as per written contract for <br />general liability. <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL~MAIL 3~ DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BKI)t~~XI>>XI. <br />x.JlailtlllOlilO6X_IIi>>lfltX_lCilCilU6J{li(~106IIiK~lO!i( <br />)@loXiltiXilOX_ <br />AUTHORIZED REPRESENTATIVE ~~____~ <br /> <br />@ACORD CORPORATION 1988 <br /> <br />City of Santa Ana <br />Building Maintenance Division <br />20 Civic Center Plaza #M-11 <br />Santa Ana. CA 92702- <br /> <br />ACORD 25 (2001/08) <br />