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fi-aw3�0�� A-2002 PD j'3-lL <br />���-i7-2�03 THU 04:09 PM fAX N0. ` <br />ACORD CERTIFICATE OF LIABILITY INSURANCE OPID T)ATEIMMI"n1YYYY) <br />WObLN-3 04 17 03 <br />PRODUCER THIS CERTIFICATE It IS6uE0 AS A MATTCA OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />ISU Ins Sry - Fullerton Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />1150 E Orangethorpe Ave, k101 ALTER THE COVERAGE AFFORDED DY THE POLICIES DELOW, <br />Placentia. CA 92870 <br />Phone:714-577-5800 Fax;714-577-5088 INSURERS AFFORDING COVERAGE INAICtt <br />i,:Sur.Eo" In$urrRA Philadelphia Insurance Comnan• <br />Women's Transitional Living 3T;1 <br />Center Post -it" fax Note 7671 <br />P.O. Box 6103 <br />Orange CA 92863 T FAmz ^n <br />COVERAGES CRJOeRL <br />THY POLICIES PNPnoN <br />OW HAVEBECNI3TO WITH <br />ORRDOURFONAMCH <br />ANY kEpLNRENENT, TERM ON LONNYYUN 01' AJJv CONTRACTOR OTHER DOLUlffrvT <br />NT.IU kl; CON"II(I <br />MAY PFRFeIu.Pr¢Iu3VHwNCE AfTORnEO BY YHE POI ICIL^OESCRI;fE0 i1C0.FlNIS SUPJEI F3X9 <br />Faze <br />AOGRCCAI[ LIMIT S SH04N FAY HAVE SEEN RE DUCED BY PAID "MS <br />gPOLICIES <br />ItTR INTO TYPE OF INSUMNCE---' POLICY <br />V— <br />GENERAL LIABILITY <br />TEACH OCCURRCIa:E1 <br />'lA'nln1.2'TOTRENTI'T)-.•�.. <br />OQO,OOO <br />S 1.000, 0.___ _ <br />A X X COMMERCIAL GCNER0. llunLITY PHPK022342 04/04/03 <br />04/04/04 PBEMISE3,gp..,Cncdl <br />IS5,000 <br />$100,00_0_ <br />eLCIM5",IAOL ��OCOUIy <br />MEO Ex°,(Myano per..ml <br />.I <br />Ix Lia. <br />PERSONAL C AOV INJURY <br />_ <br />S1 QQQ QQQ <br />1 I <br />CENCRAL AGGREGATE <br />f 2;000,000� <br />_ <br />wGGREGATUMR APPLIES PEI?. <br />E <br />_ _ <br />PRODUCTS- COMPIOI`AGG IIf�OOO, <br />OOO <br />'CAE 7NL <br />1 POLCY tCT II LOC <br />_ <br />AUTOMOBILE <br />LVVIIUTY <br />COMBINED SINGLE LIMIT <br />51,000,000� <br />_AtANYAvro <br />A <br />X <br />PUPK022342 <br />04/04/03 <br />04/04/04 <br />(Ea w-W`Bij . <br />LONMEDAVIO3 <br />DOOILYLNJURY <br />S <br />SCIIL:OULC0AV105 <br />(Per peen)—_--- <br />DODILYMNNY— <br />eCCdcIQ! <br />—,—_ <br />X <br />HIHEU AIITUs <br />�1 FC) <br />M� qq <br />1V1. <br />X <br />NON OV.NCD AUTO$ A�'P- <br />t <br />TL.. <br />O�l Ll) .DL.l� <br />(FoT <br />PROPFFTYOAMAGC <br />S <br />GARAGE LIASWtt <br />--^' <br />AWOONLY-EAACCIOCNI <br />$ <br />v ANYAUTO L„ Lira <br />Sheedy <br />3 <br />OTHFRn1AN f.A ACC <br />P HE, <br />City At[onHev <br />AWOONLN. A00 <br />3� <br />EXCESSNMBRELLA LIABILITY <br />EACI I OCCURRENCE <br />S <br />OCCUR CIAIeu MADE <br />DI:OUCTIFILE <br />R_71NIION S <br />WOkKEMPLOYERS'SCOMPENSATON ANp --_� <br />TORY ETHICS CR <br />EUABIUTY <br />EL EACH ACCIDCf:7 <br />— <br />S_ <br />ANYPROPRICTORIPARTNcwEXECUiIVe <br />El DISEASE-EA7 PLOYC <br />OCFICEHIIACMBEREXCLUOPn9 <br />$ <br />II roe. 61mkL _ntlor <br />S�YCIAL <br />— __..___._—.____. <br />EL. DISEASE. POLICY LIMIT <br />f <br />OTHER <br />�_---+ <br />!AlProperty <br />PHPK022342 <br />04/04/03 <br />04/04/04 <br />Building <br />1,4000,000 <br />IRe lacement Cost <br />Contents <br />150 E000 <br />1 FSCRIPTION OF OPLRATIONS I LOLAHON.S (VEHICLES I EXCLUSIONS ADDED BY ENOOkfiEMENT/ SPECIAL PROVISIONS <br />Jity of Santa Ara, its officers, agents employees and volunteers <br />arc named <br />�as additional insured as xespocts to their interest in <br />connection with the <br />named insured. Addit•l insured as respects to goneral liability <br />per form <br />attached to pol_ This pol is primary G is not additional <br />to or contributing <br />w/ any other insurance. *except for gross negligence and <br />willful misconduct. <br />CERTIFICATE HOLDER <br />City of Santa Ana-COBG M-25 <br />Community Development Agency <br />Carla ThompkinB <br />P.O. Box 1989 11-25 <br />Santa Ana CA 9270E <br />CiSANBS 5MOOLOANYOF THE ABOVEOESCRIBEOHOLICILSBCCANCELLEO BEFORC THE ETPIRATR <br />DATE THEREOF. THE ISSUING INSURERVIILL BROE'RVORTO MAIL 30• OAY$W ITTEN <br />NOTICE TO THE CERTIFICATE IIOLOCR NAMED TO THE LEFT, BW-cMcbRETPiRJ ULLI <br />I R <br />liCrlle )CNTATrpes— <br />ACORD 2512001/00 / / 0ACOR1) CORPORATION 1988 <br />