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12!17'07 l~C-'V 15:32 FAT 1 760 715 4547 <br />AC~R~M CERTIFICATE OF I,,.IABILITY INSURANCE bAYE(MMIDDIYYYY) <br />O6j11/2007 <br />PRODUCER (429) 954-3386 FAX (425) 451-3716 <br />Arthur ,7 _ Gallagher Risk Deanagement Services, IAC. <br />P .O . Sax 367 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONt'l'RS NQ RIGHTS UPt)N TFtE CERTIFICATE <br />HDLDER_ THIS C1=RTIFNCATE DOES NQT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED t3Y THE POLtCiES BELOW_ <br />Bellevue, FIA 98009-4357 <br />INSURERS AFFORDING COVERAGE <br />NAIC !k <br />INSURED Christiansen AmuSEm@ntS, Ina. INSURERfi American States Insurance Cv <br />P. O, SOX 997 INSURER B: -----..__.~._._ <br />Eseondida, trA 92p33-0997 I.+tSURERG: <br /> 1.N5JkER D: <br /> INSURER Er <br />R[1V F A A(, FR <br />TWE POLICIES OF INSUAANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AHOVE FOR THE POLICY PERK)D INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDffION OF ANY CONTRACT OR OTHER DOCUMENT WfT3-E RESPECT TO W HIGH THt$ t;ERTIFiirATE MAY BE ISSl1ED OR <br />IvIAY PERTAIN, SHE INSURANCE AFFORDED BY THE POLICIES DESORIBED HEREIN IS SUBJECT TQ ALL THE TEFiM5, EXCLUSIQNS AND CONDff10N$ OF ,°,L~CH <br />POLICIES. AGGREGATE LIMITS SHOW N MAY HAVE BEEN Rt-DUCED BY PAS CLAIMS_ <br />_.~~_.~ <br />RJSft DD' TYPE OF INSUflANCE POLICY NUMBER POLICY EFFECTIVE POLJCY 2XPIRATpN L)M1TS <br /> pENERAL LIABILITY EACH OCCURRENCE S <br /> CQMMERCUiL 49ENERAL LIABILITY PAMAflE TC RENTEP <br /> F.AFR4ISES.1EalsFUr~~-~_... . ~, <br /> { CLAfAAS MADE a OCCUR MED EXP (An <br />anc <br />crsan) $ <br /> y <br />p <br /> P!'=R$4NAL $ ADV IN~IIJRY $ <br /> Q$NFRAL AC}I#iEpATE $ <br /> GEN'L aQfiakEDAt`E LIMIT APPLIE5 PER: PRODUCTS - COMPNP AGCi S <br /> POLICY PERCQT- LCC <br /> AUTOAAt791LELUnBILITY 01CH49116101 04/01/2007 04/01200$ <br /> ooM61NED6INQLEUMI7 <br />~ <br /> % ANY AUTO (~ acldent) 1, 000, 04 <br /> ALL OWNED AUTOS <br /> BOOILY IRUU~iY $ <br /> <br />A SCHEDULED AUTOS (FCr Pu~o^I <br /> HIRED AUTQ$ <br /> 60DILY INJURY $ <br /> NON-0WNED AUTOS (Pr1 accident) <br /> PROPERTY DAMAGE <br /> <br />P <br />id ~ <br /> ( <br />er arx <br />en~ <br />~' GARAGELIABILRY ALrfOONLY-EA ACCIDENT $ <br />J <br />ANY AUTO <br />EA ACC <br />OTHER THAN <br />$ <br /> . <br />AUTO ONLY: - At~G $ <br /> ^CtESSAl1ieRELLA LIABIL[[Y EACH OCCURkENCE $ <br /> DCCUft ~ CLAIMS MADE AGGRL-GATE $ <br /> $ _ <br /> DEGUCT19Lc . .~ <br /> RETENTION $ S <br /> WORKERS COMPENSATION AND <br />ENPLOYERS' LUIBIGTY WC STATU- OTH- <br /> ANY PROPRiETOR,PARTNERIE%ECUTIVE E.L. E.4C}I AQ^.tDENT $ <br /> OFFICER/MEMBEft E]CCLUDED? <br />It Yes <br />dBesrlba under EL DISEASE- EA EMPLOYEE $ <br />.. <br />_ ~ <br />,. <br />. <br /> , <br />SPECIAL PROvI51ON5 neiow EL DISEASE - POL'CV L]MIT _..... <br />._... <br />,_. <br />$ <br /> OTHER <br />DESGRiPTtON QF OPERATIONS! LDCATION6 / VEHICLES / EXCLUSKlN6 ADOEO BY ENDORSENIEM! SPECIAL PROVt51QN$ <br />The City of Santa Ana, its officers, agents, empiayeea, representatives and vplunteers a=e included <br />as additional insureds but only as respects the opearation of the named insu~d per policy terms snd <br />conditions for the dates June 25, 2007 through July 3, 2007_ <br />CHRISTIAVSEN A'_+ifJSEIiE_VTS <br />City of Santa Ana <br />nttn~ Darla ~aAtpkins <br />BB$ W_ Santa Ana 81vd_, t~20U <br />Santa Ana, CA 42701 <br />AUTHOR~O REPRESENTATIVE .....:............~...... - <br />Dave HazalanjJOANNE ~ ~f~-."~'"°:"-:`- <br />A6:VKL)15[2A07)(~) r'~= t'!19)h71-A2U9 <br />SHOULb ANY aP THE ABOVE OE9GRIRED PQLIG[E9 9E frANCE1LED BEFORE YHS <br />EXPIRATION DATE TNEREOF, THE ISSUWG INSURER WIlL A9L WUL <br />30 DAYS WRITTEN NOTICE TO THE CERTGGATE HOLDER NAMED TO THE LEFT, <br />~ACORD CORPORATIDN 1988 <br />25B-123 <br />