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I , ~ ~ , ACORD. CERTIFICATE OF LIABILITY INSURANCE OP 10 J?F \ DATE {MMJODIYYYYI SYMCO-1 11/12/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Burnette Insurance Agency,Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3447 Lawrencevi11e suwanee Rd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suwanee GA 30024-2402 phone: 770-339-8888 Fax:770-339-1442 INSURERS AFFORDING COVERAGE NAlC# INSURED INSURER A: zurich U.S. Insurance Symcc GrouKan1nc. INSURER 8: The Hartford symco Merc ts Services Inc. INSURER c: Bruce Barcan 105 satellite Blvd. suite 5 INSURER 0: Suwanee GA 30024 INSURER E: THE POLICIES QFINSURANCE LISTeD B~LOW HAVE BEEN ISSUED TO THE INSIJREP NAM&O A~V5 FQR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT'WI11-j RESPECT'TO WHICH TI.M CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE~MM~ Pgk~~ff.f.t~ LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 - A X COMMERCIAL GENERAL LIABILITY 040972979 07/31/08 07/31/09 ~RE~~ES lEa occurence\ S 1,000,000 l CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $10,000 - PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2,000,000 il'~AGGREnE ILlMIT APnS\PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY j~8T LaC ~TOMOBILE UABllITY COMBINED SINGLE LIMIT $1,000,000 A ANY AUTO 040972979 07/31/08 07/31/09 (Eaaccldent) - ~ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) - ~ HIRED AUTOS BCOIL Y INJURY ~ NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident} ==rGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO NOT APPLICABLE OTHER THAN EAACC $ AUTO ONLY: AGG $ ~ESSIUMBRELLA LIABILITY EACH OCCURRENCE $1,000,000 A X OCCUR D CLAIMS MADE 040972979 07/31/08 07/31/09 AGGREGATE $1,000,000 $ 8 DEDUCTIBLE $ X RETENTION $0 $ WORKERS COMPENSATION AND X IT~'\/~';:':,us I IUJ~- B EMPLOYERS' LIABILITY 20WBPK0442 11/28/08 11/28/09 $100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $100,000 Ir~s.describeunder $500,000 S ECIAL PROVISIONS below E.l. DISEASE - POLICY LIMIT OTHER A BUSINESS 040972979 07/31/08 07/31/09 BUSINESS $2,334,000 PROPERTY RBPLACBMBNT COST !!ASIS J?ROJ?Ell.T:\!;, $500 DED DESCRIPTION OF OPERAll0NS I LOCATIONS J VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT J SPECIAL PROVISIONS ~) A.' I -~ - - - . ".VI- ..:.y, COVERAGES CITY OF SANTA ANA M12 20 CIVIC CENTER PLAZA SANTA ANA CA 92701 CITY010 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TIlE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE. TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR CANCELLATION CERTIFICATE HOLDER @ACORD CORPORATION 1988 ACORD 25 (2001/08)