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. AcDBD,. CERTIFICA~ OF LIABILITY INSUh..4NCE I DATE (MMIDDNY) 2/13/2002 PRODUCER J K INSURANCE SERVICES THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 3807 WILSHIRE BLVD. , #1100 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. LOS ANGELES CA 90010 (213) 388-9377 INSURERS AFFORDING COVERAGE ---------- -- --------..-- __________________n___ ---- - INSURED INSURER A: SCOTTSDALE INSURANCE COMPANY L.A CHA MAINTENANCE COMPANY PROGRESSIVE - ------ ------- INSURER B: INSURANCE COMPANY 18816 SAN FERNANDO MISSION BL. INSURER c' STATE.COMPEITs)\TIONFUND------ --- NORTHRIDGE, CA 91326 INSURER D: SCOTTSDALE INSURANCE COMPANY -. n ___ ----- .- ---- INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. i~f:! TYPE OF INSURANCE POLICY NUMBER P8A~ :~~50:4E- r;gIfl~~~,WN LIMITS COMBINED SINGLE LIMIT " $ 1 , 000 , 000 (Ea accident) .. .,..000__.____._ BODILY INJURY 1$ (Per person) --------- -- GENERAL LIABILITY ; X COMMERCIAL GENERAL lIABILITY t~ CLAIMS MADE [!J OCCUR A ,X--PERSONAL INJURY i---- --------- i EACH OCCURRENCE $ $ $ $ $ PRODUCTS. COMP/ap AGG $ 10/25/2001 10/25/2002 FIRE DAMAGE (Anyone fire) MED EXP (Anyone person) PERSONAL & ADV INJURY IGENERALAOO'RE&:TE CPS0008826-01 B r GEN'~GGRE,GATE-L1MITAPP~IES-PER: ~ 'PRO- , POLICY: JECT LaC I ~~.!OMOBIl.E LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-QWNED AUTOS BODilY INJURY (Per accident) 10/8/2001 10/8/2002 CA043360941 PROPERTY DAMAGE (Per accident) GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT i $ OTHER THAN EA ~_~_lS_ AUTO ONLY. AGG I $ EACH OCCURRENCE $ AGGREGATE S ------.---- $ $ ___n_ $ EXCESS LIABILITY ~~] OCCUR I CLAIMS MADE 10/25/2001 10/25/2002 D XLS0008127-01 DEDUCTIBLE RETENTION $ I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 3,000,000 100,000 5,000 3,066,000 3,060,000 3,000;-666 . !$ 2,000,000 2,000;606- C 01598835 4/9/2001 4/9/2002 TORY LIMITS ER ! E.l. EACH ACCIDENT $ f,ooo,oOO ~~SEA~E - EA EMPLOYEE $---.-.T~OOO;oo 0 'E.l.DISEASE.POLICY~~T i $ -~o-,-o6b- i OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHtcLESJEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS A ADDITIONAL INSURED PER THE ATTACHED FORM CG20101185 NAMED AS CRISTINE EE SHAW Deputy City Attorney CERTIFICATE HOLDER CANCELLATION ADDITIONAL INSUREDi INSURER LETTER: THE CITY OF SANTA ANA SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL MAIL ~_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 20 CIVIC CENTER PLAZA SANTA ANA, CA 92702 ATTN. CAROLYN FULLE ACORD 25-5 (7/97) LM: LPW v1 .9.8 on 2113102 - 17:26 by UserName AUTHORIZ~~E8E.,!..!. ~----_._..- ~ @ ACORD CORPORATION 1988 PFv1.Q.l LP: LPW vl.9.8 on 2/13102 .17:27 by UserName