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A001D CERTIFICATE OF LIABILITY INSURANCE 01/29/22 <br />'ROOUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA <br />All -Cal Insurance Agency 916 784-9070 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFI< <br />9 Y ) HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND <br />420 Folsom Road, Suite &C ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOV <br />INSURERS AFFORDING COVERAGE <br />Roseville CA 95678- <br />NSURED INSURERA: Nosprof its <br />)RANGE COAST INTERFAITH SHELTER INSURER 8: <br />1963 WALLACE AVENUE INSURERC: <br />R.ra <br />^nvFRAl.FC <br />OR <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />4SR <br />T <br />TYPE OF INSURANCE <br />POLICY NUMBERAI <br />POUCYEFFECTNE <br />DATE MMIDD <br />POUCYEXPIRATgN <br />DATE MMIDD <br />LIMITS <br />X I <br />a, ISM <br />X COMMERCIAL GENERAL LIABIUTY <br />CLAIMS MADE a OCCUR <br />R PROFESSIONAL LIAB. <br />2003-02187 <br />01/17/2003 <br />/ / <br />/ / <br />01/17/2004 <br />/ / <br />EACH OCCURRENCE <br />S 1,000,000 <br />FIRE DAMAGE An onefire) <br />$ 50,000 <br />MED EXP(An one person) <br />S 5,000 <br />PERSONAL& ADV INJURY <br />$ 1,000,000 <br />X <br />IMPROPER SEXUAL CORD <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GENL AGGREGATE <br />R POLICY <br />LIMIT APPLIES PER: <br />JECT LOC <br />PRODUCTS-COMP/OP AGG <br />S 2,000,000 <br />IMPROPER SEXUAL COND <br />1,000,000 <br />X <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />ALLOWNEDAUTOS <br />SCHEDULEDAUTOS <br />HIREDAUiOS <br />NON-OVFIEDAUTOS <br />2003-02187 <br />/ / <br />01/17/2003 <br />/ / <br />/ / <br />01/17/2004 <br />/ / <br />COMBINED SINGLE LIMB <br />$ 1,000,000 <br />BODILYINJURY <br />fp«Perna^) <br />$ <br />X <br />BOOILYINJURY <br />(Per.ww.M) <br />$ <br />X <br />PROPERTY DAMAGE <br />(Per eccNenf) <br />GARAGELIABILRY <br />ANY AUTO <br />/ / <br />/ / <br />AUTO ONLY -EAACCIDENT <br />$ <br />OTHERTHAN EA ACC <br />AUTOONLY: AGG <br />$ <br />$ <br />EXCESS <br />LIAM TTY <br />OCCUR CLAIMS MADE <br />DEDUCTIBLE <br />RETENTION $ <br />APPROVED AS 10 r- <br />/ / <br />/ / <br />RNt. <br />/ / <br />/ / <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />$ <br />$ <br />$ <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />/ / <br />/ <br />/ / <br />/ / <br />TOSUMITS OER <br />E.LEACHACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYE <br />$ <br />.Aura Sheed_y <br />I <br />EL.DISEASE-POLICY LIMIT <br />$ <br />OTHER <br />DESCRIPTION OF OPERATKINSILOCATIONSNEHICLESAXCLUSKINS ADDED BY ENDO RSEMENTISPECIAL PROVISIONS <br />'HE CITY OF SANTA AMA, ITS OFFICIALS, OFFICERS, AGENTS, EMPLOYEES, AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED AS A <br />'UNDING SOURCE REGARDING THE ACTIVITIES OF THE INSURED PER THE ATTACHED ENDORSEMENT. <br />ERTIFICATE HOLDER X I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL XKW! KX= MAIL <br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDFA NAMED TO THE LEFT, <br />CITY OF SANTA ANA XOJ�1(XASKXi1a6G1(!(12CM{R1{IW.Qfdc14ME6�J(i(del;ifl(XA(]fKH#1Wf?iMIE%()6X1(kNE <br />20 CIVIC CENTER PL./ M-25 )§x) fDC)F)lKi0Qt4XX <br />P.O. BOX 1988 AUTHO IWREYIIRESEM3XTIVE <br />SANTA ANA CA 92701- <br />CORD 25-S (7j97) aACORD CORPORATION 1988 <br />,w INS025S pgio.DI ELECTRONICLASER FORMS.I-(_)0W3-0Us `0; Page I d2 <br />