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CERTIFICATE ,JF LIABILITY INSURANc,,5. I
<br />
<br />MAGUIRE INSURANCE AGENCY
<br />LIC J~03TT645
<br />26300 LA ALAHEDA, SUITE 470
<br />MISSION VIE JO, CA 92691
<br />
<br />FEEDBACK FOUNDATION
<br />1200 N. KNOLLWOOD CIRCLE
<br />ANAHEIM, CA 92801
<br />
<br />Serial# B122t
<br />
<br />THIS C,-i~ii~CATE IS IS~;UED AS A MAi i/oK OF INFORMATION
<br />ONLY AND CONFERS NO RIGHTS UPON TIlE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOE.I~ NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
<br />
<br /> INSURERS AFFORDING COVERAGE
<br />PHILADELPHIA INDEMNITY INSURANCE COMPANY
<br />
<br />COVERAGES
<br />
<br /> ANY I~EQUlREMENT, ',ERM OR OONl~fl0N OF ANY GONTRACT O~ O'Jl-iER DOCtJMENT IM'PH RESPECT TO
<br /> ,=f.~ ,~,~u~ ~c~ , 1,000~0~__
<br /> A X c,4~v~=~cc--'='.~.LVau'n' PHPK052307 7/1/03 7/1/04 m~;o~,~(.,~,~ ~ 100,~0
<br /> X PROFE$SICNALLIAB. ~,~.&xov~ , 1,000,000
<br /> 2,000,000 AGG ~ ~.,,,'m t 2,000,000
<br />
<br /> ~ L .~=~,.Z.~E U'Un' ,*~q*Um ~ ;"~X~UCTS. ~ ~.,= S 2,000,000
<br />
<br /> Am'Cweea~ u~,au'n, PHPK052307 ?/1/03 ?1tK)4 COU~N;~ aNC-,~ [~T 1,000,000
<br />
<br /> X ~t~ AUT0~ BOOiLy iNJURY
<br />
<br /> ^ X-~u~ I~-'~Ct~MS~ PHUB019670 7/1/0:3 7/1/04 .~=~^-m ~; 1,000,000
<br /> APPROVED AS ?O FORM
<br /> Deputy City ^uorne',/
<br /> A ,=mm PHPK052307 711/03 7/1/04 BULLIONS $1,247,200
<br /> PROPERTY EMPLOYEE DISHONESTY $100,000
<br /> CRIME THEFT IN~OUT $I ,000
<br />
<br />ADDITIONAL INSURED V'flTH RESPECT TO CLAIMS ARISING OUT OF THE OPERATIONS AND USES PERFORMED BY OR ON BEHALF
<br />OF THE NAMED INSURED, SUCH INSURANCE A~ IS AFFORDED BY THIS POLICY IS PRIMARY AND IS NOT ADDITIONAL TO OR
<br />CONTRIBUTING WITH ANY OTHER INSURANCE CARRIED BY OR FOR THE BENEFiT OF THE ADOITIONAL INSUREDS, ~ THE
<br />F..~C:EPTION OF SOLE NEUGENCE OR WiLLFIA. MISCONDUCT BY THE CITY OF SANTA
<br />CANCELI.~TON EXCEPTION: 10 DAY NOTICE FOR NON-PAYMENT OF PREMIUM.
<br />
<br />CEKllrICATE HOt. DER
<br />
<br /> HOLDER NAME & ADDRE88
<br /> CITY OF SANTA ANA
<br /> COMMUNITY DEVELOPMENT AGENCY M-25
<br /> ATTN: OARLA THOMPKINS
<br /> P,O, BOX 1~
<br />
<br />ACORD 25-~ ('/'/97}
<br />
<br />CANCELLATION
<br />
<br />
<br />
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