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ACORD CERTIFICATOOF LIABILITY INSURA E DATE/ ) 12/1717/20032003 PRODUCER (916) 784-9070 All -Cal Insurance Agency 4 cY 801 Riverside Ave. Ste. #105 ATTN: BEVERLY OR NINA Roseville CA 95678- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED VIETNAMESE COMMUNITY OF ORANGE COUNTY 1618 W. FIRST STREET A a003-0`? ��-q1 SANTA ANA CA 92703- INSURER A: Nonprofits Ins Alliance INSURER B: CAROLINA CASUALTY INSURER c FIDELITY & DEPOSIT CO. INSURER D. INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADDT INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATEIMM/DD/YY) POLICY EXPIRATION DATE(MM/DD/YY) LIMITS A X GENERAL LIABILITY / / / / EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMSMADE aOCCUR 2003-04575 10/04/2003 10/04/2004 PRA MISES Ea.1TE.D nce $ 50,000 MED EXP (My one arson $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 X PROFESSIONAL LIAR. X IMPROPER SEXUAL CON. GENERAL AGGREGATE $ 2,000,000 / / / / GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 X1 POLICY 7 JECT ELOC I / / / IMPROPER SEXUAL CON. 1,000,000 A X AUTOMOBILE LIABILITY ANY AUTO / / / / COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per Person) $ ALL OWNED AUTOS SCHEDULED AUTOS 2003-04575 10/04/2003 10/04/2004 BODILY INJURY (Per accident) $ HIREDAUTOS NON -OWNED AUTOS / / / / PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG B EXCESS/UMBRELLA LIABILITY DIRECTORS 6 OFFICERS 10/04/2003 10/04/2004 EACH OCCURRENCE IS OCCUR Fx_] CLAIMS MADE AGGREGATE $ PER CLAIM $ 1,000,000 $ DEDUCTIBLE POLICY # T B D / / / / $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY / / / / TORV LPMITS ER E. L. EACH ACCIDENT — $ ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE$ OFFICER/MEMBER EXCLUDED? / / / / If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ C OTHER EMPLOYEE DISHONESTY CCP0049129-02 10/04/2003 10/04/2004 LngTS 75,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS THE CITY OF SANTA ANA, ITS` OFFICIALS, OFFICERS, AGENTS, EMPLOYEES, AND VOLUNTEERS, IS NAMED AS ADDITIONAL INSURED AS A FUNDING SOURCE CONCERNING THE OPERATIONS OF THE INSURED UNDER THIS AGREEMENT. CERTIFICATE HOLDER CANCELLATION ( ) - (714) 647-6549 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL X)ffi9MXX)W MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, CITY OF SANTA ANA/CDBG J47QNXIliKXdiX>D5751dN1A(KIXAN1SgifdO(dfX1tE(XX'D(i�X7fi(XG(YDf71Db1fX14iQfKRSXM�SIIXME COMM.DEV.AGY./L.FLORES... X a51f W1f>G AUTHORIZED REESENZATIVIE P.O. BOX 1988 M-25 SANTA ANA CA 9 702- Q_J ACORD 25 (2001108) p PS,,; INS025(010).05 ELECTRONIC _ASEA FORMS, INC. -( )327-0545 U CMAtORD CORPORATION 1988 Page 1 of 2