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From: Mandy Murphey At: G.S. Levine Ins. Svcs., Inc. FaxID: G S Levine Insurance To: Stacey <br />Date: 10/182007 02:53 PM Page: 2 of 7 <br />ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID MS °ATE IMMmvrcrrr) <br />FASIIC-1 10 18 07 <br />PRO¢ucER <br />G. S. Levine Insurance <br />Services, Ina. <br />10505 Sorrento valley Rd. 8200 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFlCATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />San Diego CA 92121 <br />phone: 858-481-8692 Fax: 858-461-7953 <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INEYPEO INSURERA OoN aNwo¢ AvosloN IvP. co. 20621 <br /> INSURaia T¢Nti1N¢N PEePNity 6 Cuvalty 36161 <br />Seatt Fazekas 6 Associates INSURERc <br />17777 Del Paso Drive INeuRex D: - <br />Poway CA 92064 <br />IrauRe] e <br />COVERAGES <br />THE POLICIEB OF NSIRWJCE LISTED BELOW hWVE BEEN ISSUED TO THE INSURED NAMED ABOYE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REOWREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE IMY BE ISSUm OR <br />MAY PERTAW, THE INSURANCE AFFORDED BV THE POLICIES OESCRIBm HQtEN 6 SUB.¢CT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BV PAD CWMS. <br /> <br />L1R <br />NbRD <br />TYPE GF MSGPANCE PGIICY NGMEHi PGLI°Y EFFECIIYE <br />GRTE MN¢lYY PG4JCY EYPpyTIO <br />GPTE DMIIS <br /> GENEPAl W1°IYTY ELH OCCURRENCE S 1,000, DDD <br />8 X X cGMMEacLiGaew+L LPHLIN 6802252L18A 06/05/07 06/05/08 pRB.16E51Ea o[mmce s 300 000 <br /> CIA&S MADEOCCUR M®EMP (NryROe peom) 810 000 <br /> PDTSDNUSADV @ILRY s 1 000 000 <br /> GENERw AGGRECdrE s 2 DDD DDD <br /> GEMLPy'GREWTE LNR PWLES PER: PRODUCTS-COMP/OP AGO S 2,000 DDD <br /> POOCY X a¢or LOC Ben. 1 DDD DDD <br /> AIIr ¢M¢PIIS LMPIDIY COMBINED SNOIE LMR <br />s1,000, 000 <br />B ANYwro 6802252L1 BA 06/05/07 06/05/06 {Ea eccvNq <br /> Au °wN®wros <br />eaGILY WLitY <br />S <br /> scls:DGLeowr°s (Par peram] <br /> X NREGwros <br />BODILY NIIA3Y <br />4 <br /> X NON~OWN®PDTO.S (Per a[tlEerR) <br /> PR°FERlY0.MYGE 1 <br /> (Per xnaerrc/ <br /> .u~nE W&I(rY wrO ONLY-EAACCIDENT 4 <br /> ANY wiO E4 ACC <br />OTIER T14W 3 <br /> wi0 ONLY: wD S <br /> E%¢E¢INNeRPW D¢BLRY FACH OCWRRENCE 5 <br /> <br /> OCLUR ^ CWMS AVDE OAORECMTE 5 <br /> 5 <br /> OEDVCTIEIE f <br /> RETENTION 1 f <br /> <br />W¢p¢!R!¢GMPENMTONIlD! WC STATV- OTIL <br />X TORY INKS ER <br />A eNLOYEN¢•uuvlurY <br />W PMTNE W EIFCUTNE 406017268 06/05/07 06/05/08 El FACH ACaDENr s 1000000 <br /> rWY PROPRIETD <br />OFFCERiIAEM~RE%CWDED] EL DISEASE-FA EM1ffLOYEE S 10000 DD <br /> Iye.NevcrlGe Wer <br />SPECVIPRW6RlNS bxlw EL °ISFASE-POIJLY INIT SIDDDDDD <br /> vTREN <br />pE¢CRPB¢N OF ¢PENOIGN91 LGGRON9 /VEMIaL! l E%CW 9NINE AD¢®PY ENCOR9ENQNT! EPlmw PROYIEW N9 <br />Re: All Operations of the named insured. <br />City of Santa Ana, its officers, employees, volunteers, representatives and <br />agents aze named as certificate holders and additional insured per the <br />attached endorsement. Insurance is Primary <br />*SO day notice of eanaellation applies for non-payment o£ premium.. XPXX <br />cars urlcn I e nuwon <br />City of Santa Ana <br />Attn: Tonic Serba <br />20 Civic Center Plaza (M20) <br />P.O. Hex 1968 <br />Santa Asla C.A 92702 <br />CITSAN- I EHOmDANY¢F1HE A¢OY6 OEGCRmE¢P¢DCa6 NE LANCELLE¢PEF¢RETNE EXRMTON <br />MTE TNEIiEGF.TNE 156GING INSGRER YRLL.WL 3D* N<Y31N,InEN <br />Nanecro THE <br />Tv TNG rEPr. e~ <br />