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OP ID SG AcrORO CERTIFICATE OF LIABILITY INSURANCE ID S DATE /DD/YYYY) 1 it(MM 18 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION TYPE OF INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE JOHN 17. MATSOCK Sr ASSOC. SNC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1750 N WASHSNGTON ST ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NAPERVSLLE =L 60563 GENERAL LIABILITY Phone: 630-505-7888 INSURERS AFFORDING COVERAGE NAIC # INSURED 'Y'\/ ^ INSURER AHartfO=d 2nsu3canc4m Ccm an INSURER B: INSURER C: Donna Desmond Associates 265 South BeVarl Gln eBlvd. Los n Ageles A 9CO24 INSURER D' INSURER E: MED EXP (Any one parson) $ -1-0,000 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DDKY POLICY DATE JMMIDDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X GOMMERCIALGENERALLIABILITY CLAIMS MADE OCCUR 83SELAVZ5827 12/01/09 12/01/10 PREMISES Eaoccurence) $300,000 MED EXP (Any one parson) $ -1-0,000 PERSONAL S ADV INJURY S 1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 XPOLICY PRO- JECT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT s3_000000 (Ea ..id—) BODILY INJURY $ (Per person) ALL OWNED AUTOS SCHEDULED AUTOS A A X HIRED AUTOS NON -OWNED AUTOS 83SELAVZ5827 63SBAVZ5827 12/01/09 12/01/09 12/01/10 12/01/10 BODILY INJURY (Per accid—t) $ X PROPERTY DAMAGE $ (Per —id—t) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO FORM AUTO ONLY AGG $ EXCESS/UMBRELLA LIABILITY ` r G v EACH OCCURRENCE $ OCCUR CLAIMS MADE p Nvv V ]- AGGREGATE $ DEDUCTIBLE�'L RETENTION $ G Stitt Ca ` y AU.O Trey $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ,(�SS�S TORY LIMITWTLS ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEM BER EXCLUDED? yes, tlas E.L. DISEASE -POLICY LIMIT $ S PR SPECIAL PROVISIOISIO NS below OTHER A Property Section 83SBAVZ5827 12/01/09 12/01/10 $500 DED $5,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ADD2T=ONAL INSURED WITH RESPECTS TO GENERAL LSA3B2L29rY: C=TY OF SANTA ANNA, STS OFFSCERS, EMPLOYEES, AGENTS, VOLUTEERS AND REPRESENTATSVES//AS REQUIRED BY WR2TTEN CONTRACT, CERTSF=CATES ARE SUBJECT TO ALL POL2CY TERMS AND COND2T20NS . li/1I\ V C LLM I I V r� SANTAAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN CSTY OF, SANTA ANNA NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL PUBLIC WORKS AGENCY ATTN : KENT JORGENSEN IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 20 C2V2C CENTER PLAZA M-36 REPRESENTATIVES_ SANTA ANNA CA 92701 AUTHOR D REPRESENTATIVE ACORD 25 (2001/081 (07 ACORD CORPORATH7N 19RR