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OP ID• MP <br />'"''??"`?? CERTIFICAT'E OF LIABILITY I?ISURAiVCE DA*EIMI."°DlYYYY' <br /> 09716/11 <br />THIS CERTIFICATE I6 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIG)173 UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES MOT AFFIRMA71V t=LY OR NEGATIVELY AMEND, EXTEND?OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IN3 URERIS),?AUTNORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If fhe t:ertlRcate holder Is an ADDITIONAL INS UR Eb, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, aub)eet to <br />Ilse ternle and condltiona of the policy, certain pollclas may require en endorsement. A statement on thla certltleate dons not confer rlgllls to the <br />aertlflcate holder In lieu of such andorsemenl(a . _ <br />I'fIPDVDER I;DO-426-26.34 <br />Rohart Ball Ina <br />Brokers Inc p <br />. <br />. 760.831-6983 <br />6266 S, MISSIort Rd. State 1006 PNO E <br />-tglc v, Eau: wlc, Ile l <br />?- <br /> <br />Bonsall <br />CA 92003 _ <br />E./i1Al <br />? --------- <br />, <br />Robort BDII ocRESa: __-_. __._ ___ __. <br /> cusTOmea to a: LINAMII <br />_ . . __ <br />_-.._. .___-.._-_ <br />- INSVRER191 AFFOROINO COVERAGE __ <br />NgICp <br />ulsuaeP Mlke Llnarea _ <br />_ 11_..- ..__ _ _.._._ . __ <br />INeuRERAIContinental Casualty - 20443 <br />1 <br />. ? <br /> <br />P.O. fox 3913 _ <br />.._..._._ ._. _. _.__. _ _..____. <br />_- <br />. <br />San clemanfe, CA 92672 INB URER B: <br /> INBURfiR 0 I __ <br /> INSURER D <br /> INBVRfiRfi ; <br />? --_.__ __-___ ___... <br /> 1 6VRERF <br />THIS IS TO CERTIFY THAT THE POLICIE6 OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INS UR EO NAMED ADOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION pF ANY CONTAACT UR OTHER DOCUMENT WITH <br />RESPECT TO WHICH THIS <br />. <br />CERTIFICATE MAY BE 163UED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES OESCRIB ED HEREIN IS SUBJECT TO ALL THE TERMS <br /> <br />EXCLUSIONS AND CONDITIONS OF SVCH POLICIES. LIMITS SHOWN A1AY HAVE BEEN REDUCED BY PAID CLAIMS. , <br />IN R TYPE OF INBUMHOE I ^pOLK:Y UMBE T DOIYYYY Mh"oOIYYYY LV.11Ta <br />OEHEFiwL LIABILITY EACH OCCURRENCE ' S 1,OB 0,00 <br /> <br />A I( COMLIERCV.I GENER <br />AL LIFBLLITY X 40268137618 07/16/11 07N 6/12 E??oaENrEt?-- -._.... <br />pgEM13E IEB OCCUrrenew [s 1,090,990 <br />? <br />_ _ ClA1M3?1AADE L^ ,OCCUR I _ <br />MED E%P An on• egyr,) -I s 10,009 <br />_.__.. .__ ... I ' PERSONFL S ADV INJVRY S 1,000,00 <br />' I GENERAL AOOREOATE 3 2,ODO,000 <br />_._ ..__ <br />- ... <br />1 <br />OEML AGOREOATE LIMIT APPLIE6 PER <br />` .. ._-__-_ <br />? <br />PRODVCT3-COIJP/OP AGO ? <br />2,000,00 <br />' <br />POLICY PRO- LOC <br />' ? ?-- <br />S <br /> AVT OMOBILH LUIBILITY COIJBINED SINGLE LVdIT <br /> <br /> <br />ANY AUTO <br />? <br />I C ,Y• <br />? <br /> <br />,t: v1L.,i <br />? , <br />tEa acudenq S <br />_ _........___._. __._, ___.... -.._-__-_____.- <br /> -- <br />__ ? <br />ALL OWNED AUTOS ? O??S1 ' <br />12?? Y gyS y <br />_ __ - EOOILY INJURY leer pore°n) I S ._. _.. .. ___ <br />ODiLY INJURY IP <br />a <br />l <br />!d <br />5 <br /> 3CHEOULED AVTOS j a ) ? <br />eI <br />ot <br />en <br />-????- <br /> <br />_-. I <br />HIRED AVT06 I ) - <br /> <br />? <br />R <br />TO <br />?( PROPERTY DALV.OE <br />(Peumtlsnp S <br />_..._..... <br />---------- <br /> <br />_ NON-ON'NEDAUTOa ? ? <br />LISA E• S <br />tt trey `s.._..,. <br />- <br /> City .. _ ..------ _..--------- - - -.... _ <br />' <br /> 9 <br /> VMBRELLA LIAR OCCVR ? 1 EACH OCCURRENCE i S <br /> EXCE98 LIAB CLAIMH-LIADEI pG=REpATE <br />? 8 <br /> <br />-__ <br />DEDVCTI6LE I ___ <br />__ _ _ _ <br />_ <br />I <br />- ? ? ?? ? .....__.• <br /> RETENTI N I ! S <br /> YJ00.KER6 COMPfiHeAT10N I <br />AHO?EMPLOYER6'LIAe1LITY YIN <br />ANY PROPRIETORIPwRTNER/FY.ECUTIVE ? <br />OFFICER/MEMBER E%CL <br />EOi <br /> <br /> <br />JA <br />I <br /> <br />• K'C STATTU- + O H- <br />-- .TORY_LIbL __.. -_ <br />E L EACH ACCIDENT 18 <br /> U <br />UD <br />(Idmtlalery to HH) <br />? _.._ ____.-__.__.__._ <br />EL p18 EASE-EA EMPIOY EF?,3 <br /> 11 yei. 6eSUIDa vnaar ?--??-- ------????? ?? <br /> OF_S RIPTION OF OPERATIONS helmv I I E L. DIBEASE -POLICY LIMIT ? S <br /> I <br />DESCRIPTION OF OPERATIONS / LOOATiON9 / VEHIOLfi9 (Anaeh ACORO t01. Add01ena1 µemalKs Sebd"b, 11 marNpaoe I> TrQebodl <br />10-day notice of cancellation for non•Payment of premium" CertillGate <br />Holder la netrfed as Additional Insured as It le required par written <br />contract. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE E%PIRATION DATE THEREOF, NOTICE WILL 'BE DELIVERED IN <br />ACC OROANCE WITH THE POLICV PROVISIONS. <br />City of Santa Ana <br />Attn: Frank Hernandez <br />20 CIvIG Center Plaza AV THORIZED REPR89ENTATV6 <br />Santa Ana, CA 92802 ?,??_ <br />O 1968-20D9 AGORD CORPORATION. All rielt la reserved. <br />ACORD 26 (2008/09) The ACORD name and logo are registered marks of ACORD