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,icORbi CERTIFICATE OF LIABILITY INSURANCE OP1D SG FDATE(MWDD/YYYYI �••� DESMO-1 11/30/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION TYPE OF INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE JOHN J. MATSOCK & ASSOC. INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1750 N WASHINGTON ST ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NAPERVILLE IL 60563 GENERAL LIABILITY Phone : 630-505-7888 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER& Hartford Insurance CSLmpany 00914 INSURER B: 12/01/10 INSURER C: PREM.i'sES Eaoccurence $300,000 Donna Desmond Associates 265 South Beverly Glen Blvd. Los Angeles CA 90024 INSURERD: 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. bK LCY TR NSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE MMIDDIYYYY POLICY EXPIRATION DATE MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERALUABILITY83SBAVZ5827 CLAIMS MADE D OCCUR 12/01/10 12/01/11 PREM.i'sES Eaoccurence $300,000 MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG s2,000,000 X POLICY PRO- JECT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $1000000 (Ea accident) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ A A X X HIRED AUTOS NON -OWNED AUTOS 83SBAVZ5827 83SBAVZ5827 12/01/10 12/01/10 12/01/11 12/01/11 BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ 1 ANY AUTO H OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE a s DEDUCTIBLE $ RETENTION $ ._..,..--. ._..::., 'y-•.��:... .._.._. _ ... $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/FXECUTIVF{� OFFICERIMEMBER EXCLUDED? �( (Mandatory in NH) H yes, describe under SPECIAL PROVISIONS below _ TORY "AI ER . E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER A Property Section 83SBAVZ5827 12/01/10 12/01/11 $500 DED $5,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY: CITY OF SANTA ANNA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUTEERS AND REPRESENTATIVES//AS REQUIRED BY WRITTEN CONTRACT, CERTIFICATES ARE SUBJECT TO ALL POLICY TERMS AND CONDITIONS. CER i IYICA I E HOLDER CANCELLATION CITY OF SANTA ANNA PUBLIC WORKS AGENCY ATTN: KENT JORGENSEN 20 CIVIC CENTER PLAZA M-36 SANTA ANNA CA 92701 ACORD 25 (2009/01) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOD SANTAM DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. The ACORD name and logo are registered marks of ACORD reserved.