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ACORD,,, CERTIFICATE OF LIABILITY INSU CE <br />DATE (MMIDD/YYYY) <br />9/19/2008 <br />PRODUCER Phone: (707)996-2912 <br />Fax: (707)996-7912 <br />Apollo General Insurance Agency, Inc. <br />P. 0. Box 1508 <br />Sonoma, California 95476 <br />INSURED <br />R.V. Thomas dba West Coast Land Clearing <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 BELOW. <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURERA: Interstate Fire & Casualty Company 22829 <br />P. O. Box 90126 <br />INSURERB: Century -National Insurance Company 26905 <br />2300 M L K Ave. <br />Long Beach, CA 90809-0121 <br />INSURERc: Fireman's Fund Insurance Company 21873 <br />INSURER D: <br />('AVGRAf=CC <br />INSURER E: <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, 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 />NSR DD' <br />ILTR <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER POLICY EFFECTIVE <br />DAN 1000113 9/17/2008 <br />POLICY EXPIRATION <br />LIMITS <br />A <br />GENERAL LIABILITY <br />✓ COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE OCCUR <br />9/17/2009 <br />EACHOCCURRENCE $ <br />1,000,000 <br />DAMAGE O RENTED <br />PREMISES (Ea occur". $ <br />300'000 <br />MED EXP (Any one person) $ <br />5,000 <br />PERSONAL&ADV INJURY $ <br />1,000,000 <br />GENERALAGGREGATE $ <br />2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO- <br />RO LOC <br />JECT <br />PRODUCTS-COMP/OPAGG $ <br />2,000,000 <br />B <br />AUTOMOBILE <br />LIABILITY WA <br />ANYAUTO c <br />ALL OWNEDAUTOIStatUs <br />i ion I re <br />alid only if writ en -cont <br />17/2009 <br />act <br />COMBINED LIMIT $ <br />(Ea accident) <br />1 ,000,000 <br />ED TOS requ <br />red of Insured, nd and <br />r <br />BODILY INJURY <br />(Per person) $ <br />HIR ED AUUTOSTOS <br />NON-OWNEDAUTOS c <br />ntract before any loss. <br />BODILYINJHIR <br />(Per acci ent)RY $ <br />j <br />verage pertains to work <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE <br />LIABILITY plrfOrMed <br />ANY AUTO <br />IN Policy er . <br />AUTO ONLY -EA ACCIDENT $ <br />OTHERTHAN EAACC $ <br />AUTO ONLY: AGG $ <br />EXCESSIUMBRELLA LIABILITY <br />OCCUR El CLAIMS MADE <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />$ <br />- <br />WORKERSCOMPENSATION AND <br />EMPLOYERS'LIABILITY <br />WCSIMIT OTH- <br />TORY LIMITS ER <br />I,NYPROPRIETC P,�PARi,NERiEXECUriVE <br />OFFICER/MEMBER EXCLUDED? <br />t.L. EACfiACCIDENT $ <br />Des, describe under <br />SPECIAL PROVISIONS below <br />C OTHER <br />Equipment Floater MX198132837 <br />9/17/2008 9/17/2009 <br />DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />E.L. DISEASE - EA EMPLOYEE $ <br />E.L. DISEASE - POLICY LIMIT $ <br />Rented Leased: <br />Per Item <br />Rented/Leased: <br />250,000 <br />500,000 <br />Re: City of Santa Ana, its officers, agents, volunteers and employees. Additional Insured coverage is included if required <br />by written contract per endorsement <br />hereto. <br />CFRTIFICOTF unl nGo <br />Holder's Nature of Interest : Certificate Holder <br />City of Santa Ana <br />20 Civic Center Plaza <br />Ross Annex (M-36) <br />Santa Ana, CA 92701 <br />ACORD 25/2nn1/nR1 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDE`��, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO <br />AUTHORIZED <br />OF A_y_Y KM 'OFON THE INSURER, ITS AGENTS OR <br />(DAGORD CORPORATION 1988 <br />