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ACORI? CERTIFICATE OF LIABILI TY INSURANCE OATS (MM,°DMYY, <br /> 11/09/2006 <br />PRDeuceR (714)905-1923 FAX (714)905-1910 THIS CERTIFICATE IS ISSUED A3 A MATTER OF INFORMATION <br />Hayward, Tilton, & Rol app Ins. Assoc., Inc. ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFICATE <br />License #0614365 HOLDER. ~YHIS CERTIFICATE DOES NOT AMEND, E%TEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW <br /> <br />888 S. Disneyland Drive #400 . <br />Anaheim, CA 92802-1846 -~/-~~(O.~~S INSURERS AFFORDING COVERAGE NAIC# <br />lusuneo Mullen & Associates, Inc. INSUREa A U.S. Fidelity and Guaranty Co. <br />1200 N. Jefferson Street 1NSUdeR B- National Liability & Fire Ins <br />Suite D w;uRERC Everest National Insurance Co. <br />Anaheim, CA 92807 INSURER^. <br /> INSURER F <br />:OVE <br />T HE P OLICIES OF INSURANCE LISTED BE LOW HAVE BEEN ISSUED TO THE I NSURED NAMED A BOVE FOR THE PO LICY PERIOD INDICATED. NOTWITHSTANDING <br />A NV R EQUIREMENT TERM OR CONDITIO N OF ANY CONTRACT OR OTHER DOCUMENT WITH R ESPECT TO WHIC H THIS CERTIFICATE MAY RE ISSUED OR <br />M AY P ERTAIN, THE INSURANCE AFFORDE D BY THE POLICIES DESCRIBED H EREIN IS SUBJEC T TO ALL THE TER MS <br />EXCLUSIONS AND CONDITIONS OF SUCH <br />P OLICI ES AGGREGATE LIMITS SHOWN M AY HAVE BEEN REDUCED BY PAIp CLAIMS. , <br />IN6R DD' rypE OF IN6URANCE POLICY NUMBE0. POLICY EFFECTIVE POLICY EXPIRgTION LIMITS <br /> GENERAL LIABILIry BK02131153 07/24/2006 07/24/2007 EACH OCCURRENCE E 1,000,000 <br /> X COMMERCIAL GENERALLIAUILITY <br />I DAMAGE TO RENTED $ 300,000 <br />Eanv <br /> y <br />CLARdG MADE J OCCUR MED EXP <br />An % <br /> _ ( <br />y ane {»rson) lO, OOO <br />A Deductible-None PER <br /> SONALa ADV wLUar s 1,000,000 <br /> __ GENERAL AGGREGATE S <br />2 <br />DDU <br />UUO <br /> 4GEN'L AGGREGATE LIMIT APPLIES PEP' PRODUCTS-COMPIOP AGG _ <br />, <br />, <br />E <br />2 000 <br />000 <br /> -_-_..____-- , <br /> X POLICY IECT FLOC <br /> Aurolxo6aE UgB1uTY BK02131183 07/24/2006 07/24/2007 T <br /> COMBINED SmGLE LIMI ' <br /> ANV AUTO (Ee acc~eem) 1,000,000 <br /> ALL OWNED AUTGS OTE: THIS COVERAGE IS <br /> <br />A <br />scHEDULED AUTns <br />FOR NON-OWNED & HIRED Eoouv NIURr <br />(Pe, wlro^I E <br /> X HIRED AUTOS AUTO COVERAGE ONLY-NO <br /> <br />X <br />NaN-owNED AUros <br />OWNED VEHICLES. eoDILY INduav <br />(Pe, a==me^o <br />$ <br /> -- --- <br /> X Deductible-None <br /> _-- PROPERTY DAMAGE $ <br /> - (Par ar<iOenD <br /> GA RAGE LIABILITY <br />AUTO ONLY ~ EA ACCIDENT <br />$ <br /> ANY AUTO <br />' <br />OTHER THAN EA ACC <br />E <br /> AUTO ONLY: AGG 8 __ <br /> E%CE65NMBRELLA LIABILITY EACN OCCURRENCE $ <br /> OCCUR i ~ CLAIMS MaOE <br />J ' <br />AGGREGATE <br />5 <br /> k _ $ <br /> DEOUCSIBLE E <br /> RETENTION $ E <br /> WORNER6 COMPENSATION AND 0100004443 061 02/04/2006 02/04/2007 X YrC STATW jOTW <br /> EMPLOYE0.6' UABILITV <br />6 ANY PROPRIETOR/PARTNERIEXECUTIVE ELEACHAC.CIOFNT $ 1,000,00 <br /> OFFICER/MEMBER EXCLUOEDP <br />IyBX 4B6CnCB O^CP/ fL OISEA6E.EAEMPLOYE E 1,000,000 <br /> SPECIAL PROVISIONS BaIOw E. L. DISEASE-POLICY OMIT g 1 OOO, OOO <br /> P°ro~essional Liability 48AE000605061 01/04/2006 01/04/2007 $1,000,000 Each Claim <br />C $1,000,000 Aggregate <br /> _ 510,000-Deductible <br />OE6LRIPT N OP O ERATIO I LOCO 10 S I VEH CLES I F,XCLU6l0 S ADDED BY ENDORSEME T! 6PECWL PROVISIgN6 <br />e: Al~ wor~C <br />er~orm <br />d ~ <br />t~ <br />C <br />t <br />f S <br />~ <br />p <br />e <br />or <br />Te <br />i <br />y o <br />anta Ana- Par <br />LS, RecreatTOn & Community Services Agency <br />y the named insured. <br />ertifisate holder is added as additional insured as per Add'1 Insured Endt. #CL/BF 22 66 11 02 <br />ttached. <br />''Note: Ten Day Notice of Cancellation for Non-Payment of Premium/Non-Submission of Payroll Report. <br />r.FRTIFIGATF HOI nFR <br /> <br />Clty of Santa And 6HOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> <br />Parks, Recreation & Community Services Agency E%PIRATION GATE THEREOF, THE ISSUING INSURER WILL ENOEAVORTO MgIL <br />" <br /> <br />Attn; Jason Gabriel 3D OAY6 WRITTEN NOTICE T07HE CERTIFICATE HOLDER NAMED TO THE LEFT <br />888 W. 5dnid And R1 Vd. ' _ qNT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />2nd Floor, M23 OF ANY RIND UPON THE INSURER, ITS AGENTS OR REPPESENTATIVEB <br />/ <br />Santa Ana, CA 92702 q / <br />Y <br />/ <br />z <br />" AIITNGRIZED REPRESENTATNE <br />/ <br />h <br />> 1 ' <br />.C <br />~ <br />_ _ V <br />~~'~'a <br />Dona- Deli ht/DLD <br />ACORD 2512001108) HAX: (7149'571-4209 // ©ACORD CORPORATPON 7988 <br />