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<br />.;lCORD,. CERTIFICA..iE OF LIABILITY INSU~NCerL~~~ D~ DATE jMMIDD/YY) <br /> 10/11/02 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Flagstaff Insurance, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />P.O. Box 1807 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />2100 E. Cedar Ave. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Flagstaff AZ 86002 I <br />Phone: 928-774-6631 Fax:928-779-1765 INSURERS AFFORDING COVERAGE <br /> I INSURER A , <br />INSURED Auto-Owners Insurance CO. <br /> INSURER B: <br /> Silver Rose Enterprises, LLC INSURER c: ~ 1/0- <br /> Marsha Rose <br /> 1319 W seasca~e Dr INSURER D: 1. , 'f I....... ~ <br /> Gilbert AZ 85 33 <br /> , INSURER E: , .., 1- ]::J 2> <br />COVERAGES ..- ~ J Illn <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 'V -.c. vv , , , v <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 />INSR' TYPE OF INSURANCE POLICY NUMBER ~2~~rM~~~rE P~l-+~~~r~If'~?N LIMITS <br />LTR' <br />[fNERAL LIABILITY .1 EACH OCCURRENCE , 1000000 <br />A xl:r:'ERC".LGENE";'-LLlABILlTY i 4558167800 10/31/02 10/31/03 FIRE DAMAGE (Anyone fire) 5100000 <br /> __ CLAIMS MADE l_ ~ OCCUR MED EXP (Anyone person) , 10000 <br /> i PERSONAL & ADV INJURY , 1000000 <br /> - ---'-'~-' --- I GENERAL AGGREGATE <br /> _..~. ' 1000000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG , 1000000 <br /> 'II 'I PRO, III <br /> POLICY i JECT LOC <br /> a-""- COMBINED SINGLE LIMIT <br /> (Ea accident) . <br /> ANY AUTO <br /> All OWNED AUTOS , <br /> BODilY INJURY I, <br /> , {Per person) <br />~.. SCHEDULED AUTOS I , <br /> HIRED AUTOS i I BODilY INJURY <br /> I {Per accident) , <br /> _-----.j NON-OWNED AUTOS <br /> i__ PROPERTY DAMAGE , <br /> (Per accident) <br /> ~R~GE LIABILITY . AUTO ONLY - EA ACCIDENT , <br /> ; ANY AUTO I OTHER THAN EA ACC , <br /> , <br /> I i AUTO ONLY: AGG $ <br /> EXCESS LIABILITY , i EACH OCCURRENCE $ <br /> ~ OCCUR C CLAIMS MADE ! : AGGREGATE . <br /> i <br /> T9;AORM $ <br /> l ~EDUCTIBLE APPRO AS . <br /> RETENTION $ . <br />i WORKERS COMPENSATION AND /' LEE SHAW i I i-~R~I~~YTSI IU~~- <br />! EMPLOYERS' LIABILITY CRI E.L EACH ACCIDENT '5 <br /> Deputy City Attorney E.L. DISEASE - EA EMPLOYEE . <br /> E.L. DISEASE - POLICY LIMIT , <br /> : OTHER <br /> I <br /> i <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />City of Santa Ana, its officers, agents, and employees are named as <br />additional insured as respects work performed by named insured <br /> <br />CANCEllATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. <br /> <br />AUm~:::5~TIV/~ <br /> <br />CERTIFICATE HOLDER <br /> <br />Y I ADDITIONAL INSURED; INSURER LETTER: <br /> <br />SANTAAN <br /> <br />City of Santa Ana <br />Lydia Morgan <br />20 Civic Center Plaza <br />Santa Ana CA 92701 <br /> <br />ACORD 25-S (7/97) <br /> <br /> <br />@ACORDCORPORATION 1988 <br />