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<br />Marsh, Inc,
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<br />5/9/2005 11:21 AM
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<br />PAGE
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<br />2/002
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<br />Fax Server
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<br />Attn: Brenda Yaung-Epps
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<br />(404)995-3074
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<br />.".;;.;__",.,?;i.,;;
<br />CERTIFICATE NlJrttSER
<br />A TL.()00791163-20
<br />THIS CERTFICATE IS ISSUED AS A. ~lATTT::R OF INFOR-MATION ON.t.y ~o CONFERS
<br />NO RIGHTS UPON THE CERTIFICA.TE HOLDER OTHER TH~ THOSE PROVIOED IN TfoIE
<br />POlleY. TI-lIS CERTFICATE DOES NaT AAlEND, EXTEND OR PJ.. TER THE COVERAGE
<br />AFFORDED BY THE POUCESOESCRI8EO HEREItI.
<br />COMPANIES AFFORDING COVERAGE
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<br />PRODUCER
<br />Marsh
<br />3475 Piedmont Road N.E., Ste 1200
<br />Atlanta, GA 30305
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<br />75142-CAS.
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<br />CO.;J'~l'Ny
<br />A FEDERAL INSURANCE CO
<br />
<br />Scantron Corporation
<br />34 Parker
<br />lrvine, CA 92618
<br />
<br />COtl.Cl1NY
<br />B AMERICAN INTL SOUTH INS. CO.
<br />
<br />INSURED
<br />
<br />COV1F'I'NY
<br />C
<br />
<br />CO',1F'AAY
<br />
<br />D
<br />
<br />~'~llr~~~"-~."""'-""4",-,"","~"''''-''j''''H~;Fn->:iiif~'' ~.'-::'","'~'i!!Z~,,:,,,,-,",,-'" V4:","-~:S"":'.p, ""-"',O:A'~
<br />:,i"",~~~\il"?Z~Jtrm<~-"~ry;::Ui!~&~~ ' '~~', .' ~"U .' __:.!IDJ;~_Q!t~~~.;,~~iWj;:RPli9Y~'n~J!t~@1d2%~&k'S$t)
<br />""15 15 TO CERTI~Y THAT PQ..ICIES OF INSJR.ANCE DESCRISS) HE!~EiN HAVE S':;:E"l ISSUED TO Tr'E INSJRED NA\'lED HER.;;:IN FOR THE PQ..IC!' P;::RIOO Ir>.OICATI:u
<br />NOf\I'iTHsrA.\lDING AAYREQUlREMENT, TER,-."OR. CClNOn1CN OF mYCQNTRjI,Cf OR OTHS QOCdv1E~T'WiTH RES'EC1TO'l\+1iCH THE a:~:nFiCATE MAY 31" 1S3....'ED OR IJ,AY
<br />P<:RrAlN, THE IN3.JRANCE .AFFORDED BY T....;E POUOESOrSCRISED HEREIN ISSU8JECT TO 1<LL THE TEF<MS; CONDITIONS AND EXD-USON5 CF SUCH POLlOe'S AGGREGATO':
<br />LiM!TS9-10v.N MAY HAVE SrEN REDUCED BYPAD C~AlMS
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<br /> co TYPE OF INSURANCE pOliCY NUIIIIBER POLICY EFFECTIVE POLICY EXPIRATION
<br /> LTR DATE (NIIIIIDDIVY) DATE4MMIDOrvY) LIMITS
<br /> A GENERAL UABILJTf 35381324 03/01105 03101106 GF'IER.A~ ,4,o.,G'1.EGA'=' $ 2,000,000
<br /> X COVlMERO.oll GENERAL LI AgiLITY PROJUCf5- Co.'PiOP AGG $ 2,000,000
<br /> l a...AiIlt5\o1AC1E o OCOJR P'::::;;S)N.IIL & ;.nVINJUR" $ 1 ,000,000
<br /> ON'_ER'S I!. CalTRI\ClGR'SPROT E,o.D"i OCCURRE1'><CE $ 1,000,000
<br /> X RINTERS J::"R.n F RE :I,oMAGE (My O"Ie~reJ $ 1 ,000,000
<br /> ,,"'EJEXP Ma'l9:8'l'C1 $ 10,000
<br /> A AUimlOBILE LIABILITY '73260213 (ADS) '03/01/05 03101/06 1,000,000
<br /> CG.1B,!'<ED S\G~= L:MIT $
<br /> A X />NY A:JTO 73260209 (TX) 03(01/05 03101/06
<br /> A i'lL OM'iED AUTOS 73260210 (VA) 03101/05 03101/06 BOJiLVINJURY $
<br /> A 9:HEDULED AUTOS 73501034 (MA) 03101/05 03101106 ('::er ~I'r,n'\;
<br /> A HIRED JlJ.JTOS 73260212 (PR) 03/01105 03101/06 80DLV:NJJRY
<br /> ("eraccdo,'t) $
<br /> r-..'~_OWNED AUTOS
<br /> OMPREHENSIVE - $1 ,000 PRO~;:I.T'f OH-M.G~ $
<br /> OLLlS10N ~ $1,000 Oed
<br /> A.;TQ QNl" -:Ai\COOENT $
<br /> ~ ,"v '.JTO GTfiER THA.\ !\L'TO o.'lL y
<br /> ~.lCri "COD:;",T $
<br /> AGGR:GATE $
<br />'. B ~CESSLlA8ILlT'r' [BE298831 B $ 5,000,000
<br /> 03/01/05 03/01106 "ACH OCCl:R"\;:I>CE
<br /> '1 U~8RELLAFCRM ,',GGR;::'GATE $ 5,000,000
<br /> i" OThER THAN LiMBR:' lA-FORM $
<br /> A I WORKERS COMP,"SATI'" AND 35381324 03/01/05 03101/06 ' OT~
<br /> EMPLOYERS'LIABILIT'( ER
<br /> I $
<br /> T,-fE PROPRIETOR; H"iCL EL DISEASE;o...lC'" L1'~IT $ 1,000,000
<br /> I PARTNER5'EXECUTI'.I': ! I f'L DISEilSE-2."C"'I =Iv1PLOY:;::E $ 1,OCO,000
<br /> CFflCERS ARt': : EXQ I
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<br />DESCRIPTIO~ Of OPERA TIONSILOCATIONSIVEHICLESISPECLAL ITEIIIS
<br />The City of Santa Ana, its officers, employees, agents, and representative are induded as additional Insured as their interest may appear per written contract.
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<br />City of Santa Ana
<br />20 CiVIC Center Plaza
<br />P_O. Box 1988
<br />Santa Ana, CA 92702
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<br />~~ "'NY OF Tl-E !'o...ICIES OESC~:BE'D ....,~= ~ BE O'.NCELLE,) !~FO~~ 11-1" ~;<.~IRA1l0N O-,lE TH""ECF,
<br />"O-I~ IN!'JlJA;" "'F~o.~DING COVE~',(i; \'tiILI ~;,;~ Mo',L ---3.0 DIo.YS '.'>'RTTEtJ f.lUfC", TO THE'
<br />CERTIFICATE I-ICUIEFl NIo.Mm l-ER"N BVT Ft','LUR= fOM':c SUCH NOTICE 9-L"-LL IMPO<E NO O~LIG'lU:N Cl'I
<br />
<br />~IABllTYlY ANY (11)0 U~ONTI-I= INg;'l.E'l....=~ORjING CCl./;'l....G,; IfS ~GENTS OR 'l.;"R;S:;N'1"&,f \n;S OIl. TI-lE
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<br />ISSl.ERClFTHlSc;e:RTIFICAT<:
<br />MARSH USA lie.
<br />BY: MIchael Dennis
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<br />Jf4J #-
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