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<br />H (i U-M- DATE (MMIDDIYYYY) CERTIFICATE OF !CITY INSURANCE
<br />61/2009
<br />PRODUCER (818) 598-8900 FAX: (818) 598-8910 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Venbrook Insurance Services, CA Lie OD80832 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND
<br />EX
<br />,
<br />TEND OR
<br />6320 Canoga Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />12th Floor
<br />Woodland Hills CA 91367 INSURERS AFFORDING COVERAGE NAIC #
<br />INSURED
<br />INSURERA Hartford Fire Insurance
<br />19662
<br />Overland Pacific & Cutler Ina. INSURERB:The Hartford
<br />100 West Broadway Suite 500 INSURER C: Westchester Fire
<br /> INSURER D.
<br />Long Beach CA 90802
<br />OVERAGES INSURER E:
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />I
<br />IND
<br />CATED. NOTWITHSTANDING ANY
<br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WATH RESPECT TO WHICH THIS CERTIF
<br />ICATE MAY BE ISSUED OR MAY PERTAIN,
<br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES
<br />.
<br />H PAID
<br />INS R ADD'L
<br />INSRI I TYPE OF INSURANCE POLICY NUMBER - POLICY EFFECTN
<br />1-DATEIMMIDDITY1 E POLICY -EXPIRATION
<br />DATE MMIDWYMRIDIY LIMITS
<br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br />
<br />
<br />A X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
<br />R Ea oaur
<br />$ 300,000
<br /> X X
<br />CLAIMS MADE.a OCCUR 72UUNTR7859 6/1/2009 6/1/2010 MEDEXP (Any one son $ 10,000
<br /> X $10,000 BI&PD Dad.
<br /> PERSONAL& A INJURY S 1,000,000
<br /> Per Claim
<br />2
<br />000
<br />000
<br /> GENL AGGREGATE LIMIT APPLIES PER:
<br />RO GENERAL AGGREGATE
<br />- ,
<br />,
<br />$
<br />$ 2,000,000
<br /> POLICY X P
<br />LOC
<br /> AU TOMOBILE LIABILITY
<br />
<br />X
<br />ANY AUTO COMBINED SINGLE LIMIT
<br />(Eaaccment)
<br />$ 1,000,000
<br />A ALLOWNEDAUTOS 72UUNTR7859 6/1/2009 6/1/2010
<br />
<br />X
<br />SCHEDULEOAUTOS
<br />r?JZ
<br />l`'1 BODILY INJURY
<br />(Per person)
<br />$
<br /> X HIREDAUTOS V
<br />?U -
<br />V
<br />
<br />X
<br />NON-0VINED AUTOS t
<br />?
<br />'
<br />V ) A BODILY INJURY S
<br /> RV
<br />A
<br />tf (Par accident)
<br /> X Comp Ded. $1,000 1
<br /> X Coll Dad. $1,000 it PROPERTYDAMAGE
<br />(Per accident) S
<br /> GARAGE LIABILITY tz Stitt
<br />Ta t
<br />TnzY
<br />AUTO ONLY -EAACCIDENT
<br />$
<br /> ANY AUTO Oily
<br /> NggiS aD? OTHER THAN EAACC S
<br /> AUTO ONLY: AGG S
<br /> EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S 2,000,000
<br /> X OCCUR n CLAIMS MADE A GRE T S 2,0001000
<br /> $
<br />B DEDUCTIBLE 72RHUTR7849 6/l/2009 6/1/2010
<br /> $
<br /> RETENTION S
<br />B WORKERS COMPENSATION AND T O
<br />EMPLOYERS' LIABILITY X
<br />ANY PROPRIETORIPARTNERE=XECUTIVE E.L. EACH ACCIDENT S 1,000,000
<br />OFFICERIMEMBEREXCLUDED?
<br />72WETQ9133 6/1/2009 6/1/2010 E.L. DISEASE-EA EMPLOYEES 1,000,000
<br />U yes. describe under
<br />SPECIAL PROVISIONS below E.L. DISEASE-POLICY LIMIT S 11000,000
<br />C OTHER Professional Liab. G24412763002 6/l/2009 6/1/2010
<br />Ea. claim $ 2,000,000
<br />Claims Made
<br />Aggregate $ 2,000,000
<br />Deductible $ 50,000
<br />DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
<br />The City of Santa Ana, its officers, agents, employees, consultants, special counsel & representatives included as
<br />additional insured per attached endorsement UCG20260704
<br />h
<br />w
<br />ere required by contract. Subject to policy terms,
<br />conditions, and exclusions.
<br />*10 DAY NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />City of Santa Ana EXPIRA710H DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
<br />Public Works Agency, M-36 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
<br />Attn: Sheri Barkley
<br />P . O . BOX 1986 FAILURE 70 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
<br />Santa Ana, CA 92702 INSURER ITS AGENTS OR REPRESENTATIVES.
<br />AUTHORIZED REPRESENTA71VE
<br />Chastity Harry/CH
<br />ACORD 25 (2001/08)
<br />lusn?r,,.,s.,,e_ ®ACORDCORPORATION 1988
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