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ACGOAD CERTIFICAT. OF LIABILITY INSURANI OP ID DATE(MM/DD/YYYY) <br />— TEE5001 07 28 03 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Advanced Insurance Marketing <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P.O. Box 4459 <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Orange CA 92863-4459 <br />Phone:714-997-8100 <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />'1 <br />INSURED A 1 aVa� M�-� ? <br />INSURER A: Philadelphia Indemnity Ins Ce. <br />INSURER B: <br />INSURERC: <br />D CTeen Ch¢llenge of So. Ca. Inc. <br />5445 Chicago Avenue <br />Riverside CA 92507 <br />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. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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 />IN <br />LTR <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE MM/DDRY <br />ICYIEXPIRATION <br />DPOLICYEFFECTIVE ATE MM/DD YY <br />lIMRS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$1,000,000 <br />A <br />X1 COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE [�C] OCCUR <br />PHPK055194 <br />07/19/03 <br />07/19/04 <br />PREMISES (Ea <br />$100,000 <br />MED EXP (Any one person) <br />$ 15 , 0 C 0 <br />PERSONAL $ ADV INJURY <br />$ 1 , O00 , 000 <br />GENERAL AGGREGATE <br />s2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS-COMP/OP AGG <br />$2,060,000 <br />POLICY JET LOC <br />Emp Ben. <br />1,000,000 <br />A <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />PHPK055194 <br />07/19/03 <br />07/19/04 <br />COMBINED SINGLE LIMB <br />(Ea accident) <br />S1, OOO,OOO <br />X <br />BODILY INJURY <br />(Per person) <br />$ <br />ALL OWNED AUTOS <br />SCHEDULEDAUTOS <br />BODILY INJURY <br />(Per accodeM) <br />f <br />X <br />X <br />HIREDAUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE <br />(Per emdent) <br />f <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHER THAN EAACC <br />$ <br />ANYAUTO <br />$ <br />AUTO ONLY: AGG <br />EXCESSNMBRELLA LIABILITY <br />EACH OCCURRENCE <br />$9,000,000 <br />A <br />X OCCUR F—ICLAIMSMADE <br />PRUB021001 <br />07/19/03 <br />07/19/04 <br />AGGREGATE <br />$ <br />$ <br />$ <br />DEDUCTIBLE <br />$ <br />X RETENTION $10 , 000 <br />WORKERS COMPENSATON AND <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNERIEXECU'TIVt <br />OFFICER/MEMBER EXCLUDED? <br />p <br />AS TO FORM <br />�L d <br />1�1Y1 <br />TORY LIMITS ER <br />E.L. EACH ACCIDENT <br />$ <br />E.L DISEASE - EA EMPLOYEE <br />$ <br />Des, describe under <br />SPECIAL PROVISIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />OTHER <br />'Deputy Cjty A <br />y <br />t;� <br />7 <br />DESCRIPTION OF OPERATIONS / LOCATIONS T VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />10 day notice of cancellation for non-payment of premium. City of Santa Ana, <br />its officers, agents, employees and volunteers are named as Additional <br />Insured as respects their interests and connection with the named insured. <br />RE: Fumding <br />11)AU9C1 <br />City of Santa Ana CDBG M-25 <br />Community Development Agency <br />P.O. Box 1988 M-25 + <br />Santa Ana, CA 92702 <br />CITSANT I SHOULD ANY OF THE ABOVE DESCRIBED POLIC ES BE CANCELLED BEFORE THE EXPIRATIC <br />'°{.. DATE THEREOF, THE ISSUING INSURERWILL4111W MAIL 30 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT <br />©ACORD <br />t4t <br />