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s N'o7-D~g-~~-~~ <br />i <br />H~~K~ C:EKTIFICATE OF LIABILITY INSURANCE OP ID LV DATE (MM/DD/YYYY) <br />LEETE-1 <br />PRODUCER 11 02 09 <br /> <br />Alliant Insurance Services Inc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> <br />Franey Muha Commercial Group ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />H <br /> <br />4530 Walney Road - Suite 200 OLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIE <br /> <br />Chantill <br />VA 20151 S BELOW. <br />y <br />Phone: 703-397-0977 Fax:703-397-0995 INSURERS AFFORDING COVERAGE <br /> <br />INSURED "- NAIC# <br /> __ <br />INSURER A: Hartford underwriters ins Co <br />3 0104 <br />Lee Technologies Group, Inc. INSURER B: H <br />tf <br />d <br /> <br />Lee Technologies, Inc ar <br />or <br />Fire Insurance Co 19682 <br />; <br />Lee Technologies Services, INc <br />12150 Monument D <br />#1 INSURER C: Hartford Casualty Ins Co 29424 <br />r, <br />50 <br />Fairfax VA 22033 INSURER D: <br /> INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED <br />NOTWITHSTANDING <br />AN <br />Y REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT . <br />WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS S <br />POL UBJECT TO ALL THE TERMS <br />EXCLUSIONS AND CONDITIONS OF SUCH <br />ICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. , <br />LTR NSR TYPE OF INSURANCE POLICY NUMBER DATECMM DD CTIVE DATE MM/DD/YYYY LIMITS <br /> GE NERAL LIABILITY <br /> <br />A <br />X <br />X <br />COMMERC EACH OCCURRENCE $ 1, OOO, OOO <br /> IAL GENERAL LIABILITY 42UUNAC6987 11/01/09 11/O1/10 <br /> <br />CLA <br />~ <br />~ PREMISES (Eaoccurence) $ 300, OOO <br /> IMS MADE <br />OCCUR MED EXP (Any one person) $ 1 O , O O O <br /> <br /> PERSONALSADV INJURY $ 1, 000, OOO <br /> <br /> <br />GE <br />N'L AGGREGATE GENERAL AGGREGATE $ 2, OOO, OOO <br /> LIMIT APPLIES PER: <br />POLICY X jE ~ <br />PRODUCTS -COMP/OP AGG <br />$ 2 , O O O , O O O <br /> LOC <br /> AUTOMOBILE LIABILITY <br /> <br />B X X ANY AUTO <br />42UUNAC6987 <br />11/01/09 COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ 1, 000, 000 <br /> X ALL OWNED AUT 11/O1/10 <br /> OS <br /> <br />SCHEDULED AUTOS BODILY INJURY <br />(Per person) $ <br /> X HIRED AUTO <br /> S <br />~~ <br />~ ~ ~ ~ ~ • ~ ~ <br />- <br /> <br />X <br />NON-OWNED AUTOS ~ BODILY INJURY <br />(Per accident) <br />$ <br /> ~ <br /> ~~ <br /> ~ PROPERTY DAMAGE <br /> <br />-._. <br />___ <br />- ---- <br />(Per accident) $ <br /> GAR AGE LIABWTY / ~--~• •~ ~ - - <br /> <br /> <br />ANY AUTO <br /> <br />:, <br />v - <br />, <br />AUTO ONLY - EA ACCIDENT <br />$ <br /> .. <br />..~ <br />, <br />~ ,.. .. ... <br /> ~ OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br />EXCESS /UMBRELLA LIABILITY <br /> <br />C X X OCCUR ~ CLAIMS MADE 42RHUAC7126 EACH OCCURRENCE <br />11/01/09 11/O1/10 AGGREGATE $ lO, OOO, OOO <br /> $ 10, 000, OOO <br />DEDUCTIBLE <br />X RETENTION $ Q <br />WORKERS COMPENSATION $ <br />AND EMPLOYERS' LIABILITY <br />A ANY PROP <br />- X TORY LIMITS ER <br />RIETOR/PARTNER/EXECUTIVI <br />~ 42yigRI3755 <br />OFFICERlMEMBER EXCLUDED? 11/O1/O9 11/O1/lO E.L. EACH ACCIDENT $ ] <br />OOO <br />OOO <br />(Mandatory in NH) „ <br />, <br />If yes, describe under <br />SPECIAL PROVISIONS below E.L. DISEASE - EA EMPLOYEE $ 1 , O O O , O O O <br />OTHER E.L. DISEASE-POLICY LIMIT $ 1, OOO, OOO <br />DESCRIP710N OF OPERATIONS /LOCATIONS !VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br />The City of Santa Ana, its officers, employees, agents, volunteers and <br />representatives are included as additional insureds on all liability <br />li <br />po <br />cies listed above. This insurance is primary and non contributory. <br />CERTIFICATE HOLDER <br /> CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />CITYOFS DATE THEREOF, THE ISSUING INSURER WILL 481KYP4FQ1~flCpD MAIL 3 O DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BiPC7Ul~@[BCPCD®35~.~36]i:L <br />City of Santa Ana °i~~10°®°~Xa~~~Dxm~Ex,~sxa~m¢~¢ <br />Attn: Thao Vu e~xsl>:alsc <br />2O Civie Center Plaza AUTHORIZ DREPRESENTATIVE <br />Santa Ana CA 92702 , <br />ACORD 25 (2009101) ©1988-2009 ACORD C RPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />