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<br />. I <br />ACORD. CERTIFICATE OF LIABILITY INSURANC~~C:l DATE (MM/DDNY) <br />10109/02 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />U & A Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Unickel & Assoc. Lic#OB27703 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P.O. Box 10727 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />San Bernardino CA 92423-0727 <br />Phone: 909-793-6Bl0 Fax:909-79B-3959 INSURERS AFFORDING COVERAGE <br />INSURED INSURER A Kemper Insurance Company <br /> INSURER B Westport Insurance Corp <br /> Harper & Assoc,Engineering,Inc INSURER c: <br /> HafBer & Assoc~ates, jne <br /> 124 E. Ontario Ave, 102-312 INSURER D: <br /> Corona CA 92BBl <br /> I INSURER E: <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 />'~f.rl TYPE OF INSURANCE POLICY NUMBER ~~t~1M~~BW~'j't: DATE MM/DDlYWN LIMITS <br /> L GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br />A 1il COMMERCIAL GENERAL LIABILITY 7RDB20693-00 OB/01/02 OB/01/03 FIRE DAMAGE (Anyone fire) $100,000 <br /> i ! CLAiMS MADE [!] OCCUR MED EXP (Anyone person) $10,000 <br /> ; <br /> ~ PERSONAL & ADV INJURY $1,000,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 <br /> I POLICY n ~~& n LOG <br /> .~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 <br />A I X ANY AUTO E7Y059B61-00 OB/01/02 OB/01/03 (Eaaccident) <br /> ~ <br /> - ALL OWNED AUTOS BODILY INJURY <br /> (Per person) $ <br /> SCHEDULED AUTOS <br /> - <br /> ~ HIRED AUTOS BODILY INJURY <br /> (Per accident) $ <br /> ~ NON-OWNED AUTOS <br /> - PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> R ANY AUTO OTHER THAN EA ACe $ <br /> AUTO ONLY: AGG $ <br /> EXCESS LIABILITY EACH OCCURRENCE $ 2,000,000 <br />A ~ OCCUR o CLAIMS MADE 7RDB20693-00 OB/01/02 OB/ol/03 AGGREGATE $ 2,000,000 <br /> $ <br /> R DEDUCTIBLE APPROVED <\S TO FO M $ <br /> RETENTION $ " $ <br /> WORKERS COMPENSATION AND ~91".L4 I tM~~II~~WS I IU~~- <br /> EMPL.OYERS' LlABIL.ITY E.L. EACH ACCIDENT $ <br /> /Laura Shec<.."W E.L DISEASE. EA EMPLOYE $ <br /> Deputy CilY Att rney <br /> E.L DISEASE. POLICY LIMIT $ <br /> OTHER <br />B Professional AEPL101610-0 OB/ol/02 OB/01/03 $2000 DED $2,000,000 <br /> Liabilitv <br />DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESlEXCLUSIONS ADDEO BY ENDORSEMENT/SPECIAL PROVISIONS <br />*Except 10 day notice of cancellation for non payment of premium. Cert. <br />holder its officers, agents, employees are named additional insured <br />regarding General Liability per attached endorsement. Re: Walnut Reservoir <br />Tank Evaluation and Specification. (A/I,XX) Fax: 714-647-3345 <br />CERTIFICATE HOLDER I y I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION <br /> CITY-Ol SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO <br /> Ci ty of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL MAIL 30* DAYS WRITTEN <br /> PublicWorks Aqency NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, J <br /> Attn: Steve Worrall I <br /> 220 S. Daisy Ave. Building A I /""\ <br /> Santa Ana CA 92703 <br /> I :. 'A";' A A Ie ~r - <br />ACORO 26-5 (7/97) , @ACORDCORPORATION 1988 <br />