|
<br />1" l'
<br />~
<br />
<br />t'"
<br />
<br />ACORD,. CERTIFICATE OF LIABILITY INSURANCE T DATE (MMIDDIYYYY)
<br />6/5/2008
<br />PRODUCER License # OB50501 (530) 668.2777 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Armstrong & Associates Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />License # OB50501 A -;;X'O~'+15 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />P.O. Box 1270 I
<br />Woodland, CA 95776-1270 INSURERS AFFORDING COVERAGE NAIC#
<br />INSURED Midori Gardens INSURER A: Berkley Insurance Group
<br /> 3231 South Main Street INSURER B: Delos Insurance Company
<br /> Santa Ana, CA 92707- INSURER c: Liberty Mutual Insurance CO.
<br /> INSURER D
<br /> INSURER E:
<br />
<br />.. ..
<br />
<br />. ,
<br />
<br />MIDOGAR-02
<br />
<br />TADA
<br />
<br />COVERAGES
<br />
<br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INOICATED. NOTWITHSTANDING
<br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />l~~: ~~~r POLICY NUMBER ~OLlCY EFFECTIVE POL.ICY EXPIRATION I LIMITS
<br /> : GENERAL L.IABILlTY I EACH OCCURRENCE S 1,000,001
<br />A xiX COMMERCIAL. GENERAL. LIABILITY PSPOO0621700 6/1/2008 6/1/2009 i ~~~~~s Ea occurence\ '1$ 50,001
<br /> ~ ~ CL.AIMS MADE [!] OCCUR MED EXP (Anyone person) , 5,00!
<br /> ,=
<br /> PERSONAL & ADV INJURY S 1,000,00
<br /> - " 3,000,00
<br /> GENERAL. AGGREGATE
<br /> ~'~ AGG~EnE ILlMIT ~PLlES PER PRODUCTS. COMPIOP AGG . 2,000,00
<br /> POLICY ~~PT n L.OC
<br /> ,
<br /> ~TOMOBIL.E LIABILITY COMBINED SINGLE LIMIT S 1 ,OOO,OO~
<br />B ~ ANY AUTO DPA5502317 6/1/2008 6/112009 (Eaaccidenl)
<br /> X AL.L. OWNED AUTOS I j BODILY INJURY
<br /> .
<br /> I SCHEDULED AUTOS i (Per person)
<br /> ,-'C- ..
<br /> HIRED AUTOS
<br /> i - BODILY INJURY S
<br /> NON-OWNED AUTOS (Per accident)
<br /> , - -.
<br /> .- PROPERTY DAMAGE $
<br /> (Per accident)
<br /> ~RAGE LIABILITY AUTO ONLY. EA ACCIDENT $
<br /> ANY AUTO OTHER THAN EAACC,' S
<br /> AUTO ONLY: AGG I $
<br /> =SESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,001
<br />C OCCUR [E] CLAIMS MADE LQ1 B71207715018 6/1/2008 6/1/2009 AGGREGATE $ 1,000,001
<br /> . .
<br /> , ~ DEDUCTIBLE $
<br /> RETENTION $ S
<br /> WORKERS COMPENSATION AND I I T~~~I~~s : I OJ~-
<br /> EMPLOYERS' LIABILITY i E.L. EACH ACCIDENT $
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE
<br /> OFFICER/MEMBER EXCLUDED? E L. DIS-EASE - EA EMPLOYEE! S
<br /> If yes, describe under EL DISEASE. POLICY L1MITT$
<br /> SPECIAL PROVISIONS below
<br /> OTHER
<br /> ,
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
<br />The City of Santa Ana, its officers, employees, agents, volunteers, and representatives are listed as additional insured per the attached
<br />ndorsement in regards to the general liability policy.
<br />RE: All California Operations 10 day notice of cancellation will
<br /> apply for non-payment of premium
<br />
<br />CERTIFICATE HOLDER
<br />
<br />CANCELLATION
<br />
<br />ACORD 25 (2001108)
<br />
<br />
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATlON
<br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAlL 3~ DAYS WRITTEN
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAIL.URE TO DO SO SHALL.
<br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
<br />T' '\,...."'1
<br />,'L \ Hf\EPRESENTATIVES.
<br />AUTHORIZED REPRESENTATIVE
<br />
<br />CW\~~
<br />
<br />@ ACORD CORPORATION 1988
<br />
<br />City of Santa Ana
<br />Alln: Jerry Jeffries
<br />20 Civic Center Plaza - Ross Annex (M-21)
<br />Santa Ana, CA 92701-
<br />
<br />.,..,'"
<br />\ ~ .
<br />
<br />; '>.,. ;[, 1. ....'.; \. .\ l.Cr
<br />
|