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<br />- <br /> <br />ACORD <br />"" <br /> <br />CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2 07/30;72007 <br />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 BELO <br /> <br />671-945-7316 <br /> <br />P~ODUCER <br /> <br />willia Borth America, Inc. <br /><16 century Blvd. <br />P. D. BOX 305191 <br />Rashvi11a, TB 312305191 <br /> <br />INSURERS AFFORDING COVERAGE <br /> <br />NAIC# <br /> <br />A- f}.OO7- / J 7 <br /> <br />INSUI'IEI'IA: American International S <br />INS"Re:Rll: CO_J;Cll and. lndulltJ; <br />INSURERO American International specialty LineD <br />INSURER D American HOM AII.urance Co an <br />IN UI'IERE: <br /> <br /> <br />26883-003 <br />19410-OOf. <br />In 26993-002 <br />19390-001 <br /> <br />INSU~ED <br /> <br />JODea 5 StokeD ADaoeiatea, Inc. <br />2600 V IItJ;llllt <br />Sacramento, CA 95919 <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REOUIREMENT. 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 />~ TYPE OF INSURANCE POUCYNUMflER PR.I-'~YEFFECTIVE PO CYEllPIRlt.TlON <br /> <br />A I ~Ne:RALlJAllIUn PROP2027883 10/1/2006 10/1/2007 <br />X OOMMEROlALGENERALLlA81Lrry <br />I OLMAS MADE W OOOUR <br />JlPollution Liab Incl. <br />.Jl Contrar.tual "Liabili t <br />~N'L.AGGI'.~1: L.IMll AP~ PEF\ <br />I pOLlovl T I ~~.,; I I LOO <br /> <br />B X ~OMOflILE UABlurrY <br />..11 ANY AUTO <br />_ ALLOWNco,DA"TOS <br />SOHEDULED AUTOS <br /> <br />c:AOH 000 URRe:NOco, <br />~~~:~~~9co,~;~~~~nO.1 <br /> <br />l.4ED EXP IAnyon."."on) <br /> <br />UMrrs <br />S <br /> <br />s <br /> <br />1 000 <br />500 <br />5 <br />1 000 <br />2 000 <br />1 000 <br /> <br />000 <br />000 <br />000 <br />000 <br />000 <br />000 <br /> <br />s <br /> <br />PERSONAL &ADV INJUI'IY <br /> <br />~c;.N e:RAL. A~~Rc;.~ATe: <br /> <br />s <br /> <br />PI'.ODUOTS-OOM~OPAGG <br /> <br />CA5054198 <br /> <br />10/1/2006 <br /> <br />10/1/2007 <br /> <br />OOMllINe:D SIN~L.e: L.IMIT <br />~Ea a",den,) <br /> <br />1,000,000 <br /> <br />80DIL V INJURY <br />iP~p.r~nl <br /> <br />5 <br /> <br />- <br />_ "'IRED AUTOS <br />_ NON.OWNEDAUTOS <br /> <br />7Y; 3//f/ <br /> <br />V Lei <br /> <br />60DILYlNJUI'IY <br />IPer .ooid""ll <br /> <br />s <br /> <br />- <br /> <br />PROPERTY DAMAGE <br />(P~ aooidonil <br /> <br />GARAGE L1ABIUTV <br />~ ANY AUTO <br /> <br />AUTO ONLV. EAAOOIDENT <br /> <br />s <br /> <br />D <br />D <br /> <br />California WC3423144 10/1/2006 <br />All OI:her WC3423143 10/1/2006 <br /> <br />10/1/2007 <br />10/1/2007 <br /> <br />OTHe:RTHAN EAAOO 5 <br />AUTO ONLY AGG Is <br />c:AOH OOOURRco,NOe: S 5 000.000 <br />AGGREGATE S 5 000.000 <br /> S <br /> 5 <br /> S <br />I I n;~~TATU-i I 10TH- <br />T RY IMITS co,R <br />EL. EAOHAOOIDENT I 1 000.000 <br />E L. DISEASE. EA EMPLOYEE 5 1 000 000 <br />EL. DISEASE - POLlOY LIMIT ,~ , nno nnn <br /> <br />c <br /> <br />~l:SSIUMllAl:LLA UAlll L.ITY PROUSO 8 5 64 6 <br />...AJ OOOUR 0 OLAIMS MADE <br /> <br />"I DEDUOTI6LE <br />-;1 Ml;Tl:NTION S , n nnt <br />WORKERS COMPENSATION AND <br />EMFL.OY~S' UASIUTY <br />ANY P ROPRIE.TOI'I!PARTNEmx ECUTIVE <br />OFFIOERlMEM8ER El(DLUDED? <br /> <br />10/1/2006 10/1/2007 <br /> <br />Hye6, de5oribeul""lOer <br />SP EOIAL PROVISIONS below <br />A OTHER <br />professional Liability <br />claillUl MadA <br /> <br />PROP2027883 <br /> <br />10/1/2006 10/1/2007 <br /> <br />$3,000,000 Escb LOSB <br />$3,000,000 Agqrafate <br />" l;n nnn ~. . L . . <br /> <br />DESCRIPTION O~ OPERATIONSILOCATlONSNEHICLE9IEXCLUSION9 ADDED BY ENDO~SEMENTISPECIAL PRDVI8IOr-lS <br />Re: On-Call Services <br /> <br />~he City of Santa Ana, its officers, agents, employees, volunteers and representatives are <br />included as Additional Insured as respects General Liability, as required bf written contract. If <br />required by insured contract, such insurance as is afforded by this policy lS primary and no other <br />insurance of the Additional Insured will be called upon to contribute to a loss. <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />Ci~y of San~a Ana <br />Planning and Building Agency <br />20 Civic Center Plass, ROSB Annex M-20 <br />P.O. Box HSS <br />Santa Ana, CA 92702 <br /> <br />SHOULD ANY 01' THE ABOVE DESC~18ED POUCIES BE CANCELLED BEI'ORE THE EXPIRATION <br />DATe n;e~eol'. THe ISSUING INSUReR WILL eNDEAVOR TO MAIL 2B.... DAYS WRITIEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO 00 SO SHALL <br />IMPOSe: NO OIlLIQATION OR LIAl:lIUTY OF ANY KIND UPON THe: INSUReR. ITS AQl:NTS OR <br /> <br />ACORD 25 (2001/08) <br /> <br />Coll:2059476 Tpl:542217 <br /> <br /> <br />"--"'.- <br />......-~ <br /> <br />-{ <br /> <br />~ACORDCORPORATION 1988 <br />