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ACORDM CERTIFICATE OF LIABILITY INSURANCE <br />o91 8/20 ) <br />PRODUCER (714)838-1912 FAX (714)838-7568 <br />CAM-BMR Insurance Agency <br />P.O. Box 1025 <br />Tustin, CA 92781 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED Orange County Children's Theraputic <br />208 North Broadway <br />Santa Ana, CA 92701 <br />INSURERA: Chaix/Western Heritage Ins. Co <br />INSURERB. <br />INSURER C. <br />INSURER D: <br />INSURER E: <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIM <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 />DO' <br />TYPEOF INSURANCE <br />POLICYNUMBER <br />POLICY EFFECTNE <br />08/02/2003 <br />POLICY EXPIRATION <br />LIMITS <br />GENERAL ABILITY <br />X COMMEP.CIALGENERALLIABILITY <br />CLAIMS MADE OCCUR <br />SCP047S16I <br />08/02/2004 <br />EACH OCCURRENCE <br />$ 1 ODO DD <br />DAMAGE TO RENTED <br />E 50,00 <br />$ 5,000 <br />NEED EXP(My one person) <br />A <br />X <br />PERSONAL & ADV INJURY <br />$ 1,000,00 <br />GENERAL AGGREGATE <br />It 2 OOO,OO <br />GEN'L AGGREGATE LIMIT APPUES PER: <br />X POLICY PRO- <br />JECT OC <br />PRODUCTS - COMPIOP AGG <br />$ Include <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />E <br />ALL OWNED AUTOS <br />SCHEOULEDAUTOS <br />BODILY INJURY (Per <br />(Per person) <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />BODILY INJURY <br />(Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per awdera) <br />$ <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />ANY AUTO <br />OTHER THAN EA ACC <br />$ <br />AUTO ONLY: AGO <br />$ <br />EXCESSIUMBRELLA LIABILITY <br />OCCUR CLAIMS MADE <br />AS <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />E <br />$ <br />DEDUCTIBLE <br />Laura S)1CC <br />$ <br />RETENTION E <br />it <br />It <br />WORKERS COMPENSATION AND <br />EMPLOYERa I-MBILITY <br />44C STATED OTH- <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETORPARTNEREXECUTIVE <br />OFFICERMEMBER EXCLUDED? <br />E.L. DISEASE - EA EMPLOYE <br />E <br />Des, dmcnbe under <br />SPECIAL PROVISIONS belay <br />E, L. DISEASE -POLICY LIMIT <br />$ <br />OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br />dditonal insured as per Exhibit B attached. <br />Subject to 10 days notice of cancellation due to non-payment of premium. <br />THE CITY OF SANTA ANA <br />Community Development Agency <br />Attn: Carla Tompkins <br />P.O.Box 1988 <br />Santa Ana, CA 92702 <br />ACORD 26 (2001I08) FAX: <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL K9000tM MAIL <br />*30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />KMKKi(yd(LXMXlN(X11(KIK11(KXX <br />©ACORD 96RPORATION 1988 <br />