Laserfiche WebLink
rli.mm- Sn759 <br />MOULPOLI <br />ACDRD.P CERTIFICATE OF <br />LIABILITY <br />INSURANCE <br />o2i�4/os°A"' <br />PRODUCER <br />HRH Professional Practice <br />POLICY EFFECTIVE I ICYEXPIRATION <br />DATE IMMIOD DATE dIDDMI LIMITS <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 />Insurance Brokers, Inc. <br />BKO1830239 <br />ALTER <br />THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />2030 Main Street, Suite 350 <br />Irvine, CA 92614-7248 <br />FIRE DAMAGE (Anyone fire) $SOO QQQ <br />INSURERS AFFORDING COVERAGE <br />INSURED <br />NsuRER A: <br />Fidelity and Guaranty Insurance Comp <br />Moule & Polyzoides, Architects <br />MADE OCCUR <br />INSURER B: <br />St. Paul Protective Insurance Co. <br />180 E. California Boulevard <br />PERSONAL B ADV INJURY $2 QQQ OOO <br />INSURER C: <br />Pasadena, CA 91106 <br />INSURER D: <br />ATTN: REX UBER-626 844 2410 <br />INSURER E: <br />ES <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 />HN—SR <br />TYPE <br />OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE I ICYEXPIRATION <br />DATE IMMIOD DATE dIDDMI LIMITS <br />A <br />GENERAL LIABILITY <br />BKO1830239 <br />06/30/05 <br />06/30/06 <br />EACH OCCURRENCE $2 000 O00 <br />FIRE DAMAGE (Anyone fire) $SOO QQQ <br />X COMMERCIAL GENERAL LIAR ILITY <br />COMM <br />MED EXP one person) $10000 <br />MADE OCCUR <br />PERSONAL B ADV INJURY $2 QQQ OOO <br />GENERAL AGGREGATE $4 QQQ QOO <br />GENL AGGREGATE LIMITAPPLIES PER: <br />PRODUCTS - COMP/OP AGO $4,000000 <br />POLICY PE OT LOC <br />A <br />AUTOMOBILE <br />LIABILITY <br />BKO1830239 <br />06/30/05 <br />06/30/06 <br />COMBINED SINGLE LIMIT $2,000,000 <br />(Ea accident) <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY $ <br />(Par person) <br />BODILY INJURY $ <br />(Per accident) <br />X <br />X <br />HIREDAUTOS <br />NON-OWNEDAUTOS <br />PROPERTY DAMAGE $ <br />IPerawdenp <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EAACC $ <br />ANY AUTO <br />AUTO ONLY: AGG $ <br />A <br />EXCESS LIABILITYBK11830239 <br />06/30/05 <br />06/30/06 <br />EACH OCCURRENCE $2 000 000 <br />AGGREGATE $2 OOO OQO <br />X CLAI7MADEOCCUR <br />— <br />$ <br />i <br />$ <br />HDEDUCTIBLE <br />RETENTION s <br />B <br />WORKERS COMPENSATION AND <br />BW02148236 <br />09/01/05 <br />09/01/06 <br />X TORVTATK- <br />U- OTR <br />E.L. EACH ACCIDENT $1,000,000 <br />EMPLOYERS' LIABILITY <br />E.L. DISEASE - EA EMPLOYEE 0,000,000 <br />E.L. DISEASE POLICY LIMIT $1.000,000 <br />OTHER <br />DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />ALL OPERATIONS. GENERAL LIABILITY: THE CITY OF SANTA ANA, ITS OFFICERS, <br />EMPLOYEES, AGENTS,VOLUNTEERS AND REPRESENTATIVES ARE NAMED ADDITIONAL C. <br />INSURED PER ENDT ATTACHED. <br />CITY OF SANTA ANA <br />PLANNING & BLDG. AGENCY -M20 <br />ATTN: LUCY LINNAUS <br />20 CIVIC CENTER PLAZA <br />Santa Ana, CA 92701 <br />95.S 17/9711 -f 9 flS3d7R35/M3d7RAA <br />SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WINX"K=Xft TO MAIL 3Q—DAYS WRITTEN <br />NOTICE TOTH E CERTIFICATE HOLDER NAM ED TOTH E LEFT,J9NrAXXWXX300Q*00=k <br />AUTHORIZED REPRESENTATIVE <br />CCL © ACORD CORPORATION 198E <br />