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cQ& CERTIFICATE OF LIABILITY INSU^ANC iEH136 P9 DA06/0�5/03 <br />iPFWDUCER THIS CERTIFICATE Ib ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />WILLIAMS INSURANCE BROKERS HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />609 N. Harbor Boulevard ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Fullerton CA 92832-1596 <br />Phone:714-526-5588 Fax:714-526-4487 INSURERS AFFORDING COVERAGE <br />INSURED INSURER A: North American Elite <br />A-dn03-074—4-Z INSURERB: NIAC <br />Shelter for the Homeless INSURER C: <br />15161 Jackson Street INSURER D: <br />Midway City CA 92655 <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 />INSR <br />UrR <br />TYPE OF INSURANCE <br />PCL:CY!!UMBE.^. <br />POLICY EFFEUTIVE <br />DATE <br />POLICY EXPIRATION <br />DATE.MMIDDY/ <br />L!ALITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$1000,000 <br />FIRE DAMAGE (Any ale fin) <br />f 100,000 <br />B <br />X COMMERCIAL GENERAL LIABILITY <br />20030143IMPO <br />05/19/03 <br />05/19/04 <br />CLAIMS MADE ❑X OCCUR <br />MED EXP(Any a person) <br />$10,000 <br />PERSONAL B ADV INJURY <br />$1,000,000 <br />X liQnor liability <br />$1,000,000 <br />GENERAL AGGREGATE <br />f 3,000,000 <br />GENL AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS-COMP/OPAGG <br />$1,000,000 <br />17 POLICY JEC LOC <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />Fa sdwQ ESINGLE LIMIT <br />f 11 000 , 000 <br />BODILY INJURY <br />(PwP rs ) <br />s <br />B <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />2003-01431-NPO <br />05/19/03 <br />05/19/04 <br />X <br />BODILY INJURY <br />(Per acaaem) <br />f <br />HIRED AUTOS <br />NON-OWNEDAUTOS <br />PROPERTY DAMAGE <br />(Per acwlenQ <br />S <br />GARAGE LIABILITY <br />AUTO ONLY -EA ACCIDENT <br />f <br />OTHER THAN EA ACC <br />AUTO ONLY: AGG <br />f <br />ANY AUTO <br />f <br />EXCESS LIABILITY <br />APPROVED <br />AS 10 <br />) i lY <br />EACH OCCURRENCE <br />f <br />OCCUR CLAIMS MADE <br />AGGREGATE <br />f <br />f <br />f <br />DEDUCTIBLE <br />RETENTION f <br />La a Sh <br />edy <br />f <br />WORKERS COMPENSATION AND <br />EMPLOYERa'L:AaiLITi <br />TORY LIMBS ER <br />-L_._ <br />E.L. EACH ACCIDENT <br />S <br />E.L'ISFASE-FA EMPLOYEE <br />f <br />E.L. DISEASE -POLICY LIMIT <br />f <br />OTHER <br />A <br />Property Section <br />CWB00006730101431 <br />05/19/03 <br />05/19/04 <br />Spec Form See Below <br />Deductibl $2 500 <br />DESCRIPTION OF OPERATONSA.00ATIONS/VEHICLES/FXCLUSIONS ADDED BY ENDORSEMENT/SPECULL PROVISIONS <br />cart holder & its officers, employees, agents & representatives are named as <br />add-1 insureds with regard to liability per A/I form attached for: <br />426 S. Birch St. at $240,000 and 518 S. Birch St., at $141,000 and 1921 W. <br />Washington at $283,000 in the city of Santa Ana, Ca. *10 day notice for <br />non-payment. xxx Revised 6/5/03 pw <br />4CnI irj /1IC nwLVCR I I <br />CITYOFA <br />City of Santa Ana, Community. _ <br />Development Agency (M-25) <br />CDBG Grant, John Maloney <br />P O Box 1988 <br />Santa Ana, CA 92702 <br />UANY =L_LAI IMY <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILLiNBEAVGR36 MAIL *30 DAYSWRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />OR <br />n <br />[Orel c73671:7_V1Is, : iiFFl i <br />M <br />