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/II~/lY/// /~ / // <br />ACORD CERTIFICATE OF LIA81L"ITY INSURANCE CSR PF DATE iMMIDD/YVYY) <br />SYMCO-1 OS 17 07 <br />PRODUCER <br /> <br />Burnette Insurance Agency, Inc. <br />3447 Lawrenceville Sumaaee Rd. 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 />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Suwanee GA 30024-2402 <br />Phone:770-339-8888 Fax:770-339-1442 <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURED q. 2006-~r <br />5 INSURER A: Zurich V.S. Insurance <br />j INSURERS: The Hartford <br />a q/~'~] ~y <br />S CO Group Inc • r' ~ M1`^~ - I "~) INSURER C: <br />1D5 Satell3~e Blvd. Suite S <br />G <br />30 <br />24 INSURER D: <br />Suwaaee <br />A <br />0 INSURER E: <br />COVERAGES <br />THE PoLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED TO THE INSURED NAMED A80VE FOR THE POLICY PERIOD INDICATED. NOTWRHSTANOING <br />ANY REOWREMENi, TERM OR CONDITIONOFANY CONTRACT OR 07HER DOCUMENT W ITH RESPECT TO WHICH THIS CERTIFICATE MAV BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED 8V THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONOR'IONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BV PAID CLAIMS. <br />LTR NS TYPE OF INSURANCE POLICY NUMBER GATE MMRIOIYY GATE MIDO LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $1, QQO, QQQ <br />A X COMMERCIAL GENERALLIABILITV 040972979 07/31/07 07/31/08 PREMISESEeoccurence $300,000 <br /> CLAIMS MADE OCCUR MED EXP (Any ana person) $1Q, QQQ <br /> PERSONALBADV INJURY $1,000, QQQ <br /> GENERAL AGGREGATE $2, QQQ, QQQ <br /> GEN'LAGGREGATE LIM <br />IT APPLIES PER: PRODUCTS-COMPlOPAGG E2,000, QQQ <br /> O <br />R POLICY JELQT LOC <br /> AUT OMOBILE LIA81LI7Y COMBINED SINGLE LIMIT <br />000,000 <br />$1 <br />A X ANVauro 040972979 07/31/07 07/31/08 (Eeaodaem) , <br /> ALL OWNED AUTOS BODILY INJURY <br />$ <br /> SCHEDULED AVTOS (P%persan) <br /> X HIRED AUTOS BODILY INJURY <br />$ <br /> - X NONAWNED AUTOS (Per accitlenq <br /> PROPERTY DAMAGE <br /> <br />(Per accltlenQ $ <br /> GA RAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANV AUTO NOT APPLICABLE OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> E%CESSNMBRELLA LIABILITY EACH OCCURRENCE $1, QQQ, QQQ <br />A X OCCUR ~CLAIMSMADE 040972979 07/31/07 07/31/08 AGGREGATE $1,000,000 <br /> $ <br /> DEDUCTIBLE $ <br /> X RETENTION $ Q $ <br /> WORKERS CDMPENSATION ANO X TORY LIMITS ER <br />B EMPLOYERS'LIABILITV <br />ECUTNE <br />~ 20SVBPK0442 11/28/06 11/28/07 E.L. EACH ACCIDENT $lOO, QQQ <br /> OFFICERlMEM ER <br />E%CLUDEO? EL DISEASE-EA EMPLOYE $SOO, QQQ <br /> tt ye,, aaa~lba under <br />SPECIAL PROVISIONS below <br />E.L DISEASE-POLICY LIMIT <br />$$QQ, QQQ <br /> OTHER <br />A BUSINESS 040972979 07/31/07 07/31/08 BUSINESS $2,334,000 <br /> PROPERTY aanvc~rr mnx sAexe PROPERTY $500 DED <br />DESCRMTION OF OPEM7IONS 1 LOCATION91 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br />~~ <br />Certificate holder is listed as additional insured as per contractual <br />~~ AS TO FOIU,j <br />obligation./Faxed 714-647-5406.SE8 REVISSD WC INFORMP.TION. <br />i <br />aura Stitt Sbeed <br />Assistant Cit <br />t.~rt I Irn.n I e na/LU~rt <br />City of Santa Ana <br />Linda Kelley <br />20 Civic Center Plaza <br />Santa Ana CA 92702 <br />SANTAAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 D GAYS ViRITTEN <br />NOTICE TO THE DERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. <br />