<br />'I'
<br />
<br />AceRD,.: 'CERTIFICA TE OF LIABILITY INSURANCE I DAlE (MMlDDIYYYY}
<br />5/5/2005
<br />~ODUCER (510) 547-3203 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />!:I"J~ Risk insurance Brokers ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />Ii 529776 AlTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />'soo Christie Avenue
<br />Eme~II~, CA 94608 INSURERS AFFORDING COVERAGE NAIC#
<br />,
<br />INSURED Harris and Associates Inc. INSURER'" Atlantic Specialty Insurance Company
<br /> Alln: Tracy Rapozo INSURER e: Hartford Fire Insurance Co.
<br /> 120 Mason Circle INSURERC:American Guarantee & Liability
<br /> Concord, CA 94520-1238 INSURER 0: Alaska Nationsllnsurance Company
<br /> A-2-DD5- 030 INSURER E: Continental Casualtv Co.
<br />
<br />>
<br />
<br />HARRAND.c1
<br />
<br />AFDI
<br />
<br />COVERAGES
<br />
<br />!
<br />! I
<br />
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
<br />ANY REOUIREMENT, TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE PCLlCIES DESCRIBED H.REIN IS SUBJ.CT TO ALL TH. TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />~ POUCY NUMBER POUCY EFf'ECT1VE P2~, EXPIRAT10N UMIT8
<br /> ~ERAL LIABILITY EACH OCCURRENCE . 1,000,0001
<br />A X ~ .5'MERCIAL GENERAL LIABILITY 718.cO-8245.cOOO 8/1/2004 8/1/2005 PREMISE aCCC:;~\ . 50,iiOiili
<br /> ClAIMS MADE ~ OCCUR MCD EXP IAny one perSon) . . 5JMlOl'
<br /> , X..X....C....U.. 1,000,0001
<br /> PERSONAl & AnV INJURY $
<br /> , X Severability of Interast GENERAL 'AGGREGATE . 2,000,001
<br /> ~'~ AGG~EME,lIMrr APP~t PER: PRODUCTS M COMPfOP AGG , 2,ooo,Oiil
<br /> POLICY X ~,Q;: \.00
<br /> ~UTOM08JLE UABIUTY COMBINED SINGLE LIMIT . 1,000,001
<br />B ~ ANY AUTO 57UENUL6878 8/112004 8/112005 (Ea accident)
<br />\; i . . --:- ALL OWNED AUTOS BODILY INJURY
<br />i I -d- SCHEOULSO AUTOS (Ptirperaon) $
<br /> . ~ HIRED AUTOS BODILY INJURY $
<br /> ~ NON-OWNED AUTOS (Per accident)
<br /> - PROPERTY DAMAGE $
<br /> (Pereccidenl)
<br /> ~~GE UASOlTY AUTO ONLY w EA ACCIDENT .
<br /> ANYAUTQ OTHER THAN EA ACC .
<br /> AUTQONLY: AGe; $
<br /> ~~SlUMBRELLA UABIUTY EACH OCCURRENCE . 5,000,000
<br />C X OCCUR 0 ClAIMS MADE AUC-9305561.c2 8/1/2004 811/2005 AGGREGATE . 5,000,001
<br /> .
<br /> R DeDUCllBle $
<br /> RETENTION , .
<br /> WORKERS COMPENSATlON AND X 1~:rf.])I;,1 10m-
<br />D EMPLOYI!!RS' UABIU'TY 04HWD40007 8/112004 6/1/2005 . 1,000,00(
<br /> ANY PROPRlETORIPAR1'NERlEXECUT1VE E.\.. EACH ACCIDENT
<br /> OFFICERlMEMBER EXCLUDED? E.L. DisEAse. EA EMPl..OYE . . 1,000,00
<br /> ~~~~~NSbelow E.L DISEASE ~ POLICY LIMIT . 1,000,00
<br /> OTHER
<br />E Professlonel Liability AEA 113822501 811/2004 811/2005 Per Claim: 5,000,000
<br />E See Remarks on next pg. AEAl13822501 811/2004 8/1/2005 Asgreg.te; 5,000,000
<br />DESCRIPTION OJ: OPERA't1'*S I t,.OCA.TlQNS lVEHK:LES J EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAl. PROVISIONS APPROVED AS TO FORM
<br />In the event of cancellation for non-payment of premium, a 10 day notice will apply.
<br />~e; O?-Call Civil Engineering, Architectural & Landacaping Services (H&A #042.c406.01) ,. ,1,.-" dJ.
<br />YY-b ~., /I~
<br /> his c~r1Iflcate cancels and replaces certificate Issued on 3124/05.) Laura S~ Sheedy
<br /> Assistant . . .. ",
<br />
<br />1.1..' ~'
<br />:"
<br />'Ii
<br />III:
<br />! ~
<br />
<br />i.........: ~":
<br />i 1'1' ,il
<br />i ':1
<br />II '
<br />, '
<br />, .. II
<br />'..' '.'1\
<br />';1 i '
<br />I ,i
<br />
<br />CERTIFICATE HOLDER
<br />
<br />CANCELLATION
<br />
<br />City of Santa Ana SHOULD ANY Of lltE ABOVE DESCRIBED POUClES BE CANCELLED BEFORE THE EXPIRATION
<br />Alln: Jason Gabriel, PE DATE THEREOF, THE ISSUING ,NSURER WlL~MAIL 3!...- DAYS WRITTEN
<br />Civic Hall. Ross Annex NOTICE T01ME CERTIFICATE HOLDER NAMED TO THE LEFT, ~~VMV,
<br />20 Civic Center Avenue, M-36
<br />Santa Ana, CA 92702- ~
<br /> AUTllORlZED REPRESENTATIVE ...<O--~ ~
<br />
<br />ACORD 25 (2001108)
<br />
<br />@ACORD CORPORATION 1988
<br />
<br />! I"~
<br />
<br />'11,
<br />
|