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tilwl eI 1 <br />5/26/2010 <br />6. � o CERTIFICATE OF LIABILITY INSURANCE OATEIMMIOOM2010 <br />� 5/26/0 <br />PRODUCER (818) 598-8900 FAX: (818) 598-8910 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Venbrook Insurance Services, CA Lic OD80832 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />6320 Canoga Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />12th Floor <br />Woodland Hills CA 91367 INSURERS AFFORDING COVERAGE NAIC # <br />INSURED <br />Overland INSU_RERA Hartford Fire Insurance Co <br />-Z' <br />I 19682 <br />Pacific b Cutler Inc. NSURERB The Hartford 29424 <br />-- <br />3750 Schaufele Ave., Suite150' INsuRER c.WeatchesterF4.re Insz <br />SURERD. <br />urance -21121A`2w6-o�`i N —_.— <br />Lon Beach CA 90808 <br />geacINSURER E. <br />COVERAGES <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 <br />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 />INSRAADD L___. —E IF - __ <br />POLICY NUMBER POLICY EFFECTIVE E%PIRATION'i <br />LTRINSRD PIOATE <br />OMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />- <br />S 1, 000, 000 <br />X I COMMERCIAL <br />... _.., <br />DAMAGE 'rOTLENTEIS -' ' <br />PREMISE3^LEeoamn—) <br />S 30 00_ <br />A X ADE XL OCCUR <br />�; 72ULRIxxT859 6/1/2010 6/1/2011 <br />MED EXP (Any one Person) <br />IS 10,000 <br />$10,000 BIfiPO Ded. <br />PERSONAL S ADV INJURY <br />..... <br />S �O000OOO <br />Yer Clasm _ <br />GENERAL AGGREGATE <br />S 2 000 , 000 <br />GE( <br />N'LAGGREGATELIMIT APPLIES PER'. <br />PRODUCTS-COMPpP AG__G <br />S 2,009,000 <br />POLICY X PRP r LOC <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />IS 11000,000 <br />X <br />ANY AUTO <br />(Eeamident) <br />' <br />A <br />_ <br />ALL OVM ED AUTOS 72UUNTR7859 6/1/2OlO <br />6/1/2011 <br />_. <br />BODILY INJURY <br />X <br />SCHEDULED AUTOS <br />(Pe- Person) <br />S <br />X <br />-- <br />X <br />X <br />HIRED AUTOS <br />C <br />1 ♦ TO FORM <br />NON -OWNED AUTOS � %�S <br />pppROV <br />BODILY INJURY <br />(Per a¢kent) <br />S <br />X <br />Comp Ded <br />------ <br />'S <br />X <br />_$1,000 <br />Coll Ded $1,000 <br />PROPERTY DAMAGE <br />1 (Per aaent) <br />GARAGE LIAEWTY <br />—�ANY <br />aura <br />Stu ShOedy <br />AUTO ONLY - EA ACCIDENT 'S <br />- <br />AUTO <br />✓ <br />—__—._- <br />tosistaD <br />Ly AtIOrne <br />.OTHER <br />THAN EA ACO <br />S <br />AUTO ONLY:-AGG <br />S <br />EXCESS I UMBRELIA LIABILITY <br />EACH OCCURRENCE <br />S 2 000,000 <br />X OCCUR CLAIMS MADE <br />- <br />AGGREGATE <br />Is 2, 000,000. <br />I <br />3 <br />H <br />DEDUCTIBLE <br />j121iBUTR7849 <br />6/1/2010 6/1/2011 <br />s <br />I RETENTION S <br />S <br />B <br />CION <br />AHD EMPLOYDERS' MPENSAUASIUTY <br />YO <br />I,X <br />WC STATU <br />-TORY LIMITS _ER <br />_RKERS <br />ANY PROPRIETORIEXCLUDRIE%ECUTIVE <br />OFFICE <br />In BER EXCLUDED' <br />NH) <br />1 <br />16/1/2010 <br />E L. EACH ACCIDENT <br />j <br />FE.L <br />5 1,000, 000 <br />wry <br />(Mendsmryln <br />72WETQ9133 <br />6/1/2011 <br />DIBEASE EA EMPLOYEES <br />1 000 000 <br />Pyy <br />SPECnFeunder <br />ICALAL PPROVISIONS below <br />I <br />EL DISEASE POLICY LIMIT <br />I S 1 000,000 <br />C <br />OTHER Professional Liab. <br />IC24412763 0031, 6/1/2010 16/1/2011 <br />Ea Claim <br />$2,000,000 <br />Claims Made <br />Aggregate <br />$2,000,000 <br />50 000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />The City of Santa Ana, its officers, agents, employees, consultants, special counsel S representatives <br />included as <br />additional insured per attached endorsement #CG20260704 where required by contract. <br />Subject to policy <br />terms, <br />conditions, and exclusions. <br />e10 DAY NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM <br />City of Santa Ana <br />Public Works Agency, M-36 <br />Attn: Sheri Barkley <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <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 TME CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />AUTHORIZED REPRESENTATIVE <br />Sharon Jones/SHAJON <br />ACORD 25 (2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. <br />INS025 (2CD901) The ACQRD name and logo are registered marks of ACORD , <br />