Laserfiche WebLink
RightFax <br />9/11/2003 7:Z8 PAGE 2/3 RightFax <br />ACORD_ CERTIFICATE OF LIABILITY INSURANCE Eage 1 of 2 <br />09/11/2003 <br />PRODUiPA 877 -559 -6769 <br />Willi. Warih America, Inc. - agi,a,a cart Centex <br />11zo1 N. Tatum Blvd, <br />suite 300 <br />Fhoesia, Ar 850,711 <br />THIS CERTIFICATE JS 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 />INSURED .Sulkers of St. Sosaph of Orrnge <br />1110 11outh Batavia <br />Oraa", CA 93860 -Mltr 5<24 ;YZ-fe <br />- oozI -o 4- r ✓ <br />INSURERA: American Unity O.oqp Ltd 00929 -001 <br />IN911XER0: <br />GmEnALWIMITC <br />RISURERD: <br />RE: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLICY PERIOD NDICATEO. 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 HERON IS SUBJECT TO ALL THE TERMS. EXCLUSIONSANO CONDITIONS OF SUCH <br />POLICIES. AGZIREOATE uurrs SHOWN MAY MVEBE04 REDUCED BY PAID CLAIMS. <br />IN <br />TYPEOFNSURANCE <br />POLICfALOWER <br />PO C <br />POLICY <br />UNITS <br />A <br />GmEnALWIMITC <br />MMEPCNLGENERM-LI BUTY <br />QAMSNADE ® OCCUR <br />BSI -CGL -03-01 --019 <br />APPIRO <br />6/30/2003 <br />ED AS TO <br />6/30/2001 <br />FORM <br />EACHOCCURRENCE <br />$ <br />RFIEDAMAGE) q k# <br />6 <br />LFD EXP . Pem <br />$ <br />PEiSCNAL&ADVIWURY <br />0 <br />GENERALAGOREGATE <br />5 2,090,000 <br />GENLAOUEGATE <br />Poucy <br />LUT APPLES PER <br />Lee <br />PRODUCTS- COMROPAGG <br />E <br />AVrOMOO <br />LEUAMUTY <br />ANYADTO <br />ALLO.BEDAUIOS <br />9OEDUEDAUT08 <br />HRFDAUTOS <br />NDNOWTEDAUTOS <br />Laura Sht,dy <br />Deputy Cily <br />CdIRWFD SINCIE LIAR <br />lEa ar�aeEO <br />E <br />Attorney <br />BOMYIN"Y <br />B <br />BODILYNJUNI' <br />�Fafaida11) <br />11 <br />fPYSOGkMIQVAAGE <br />11 <br />OAIMOEUAaUTT <br />ANYANO <br />AUTOOMN-EAACCIDEiT <br />E <br />EAACC <br />OTHERTRAN <br />AAffOONLY: AO(i <br />II <br />EXOEBB UA&LrIY <br />OCCUR FI CLAMS MADE <br />DEDUCTIBLE <br />RETENTION 8 <br />EACHOCCURFENCE <br />j <br />AGGREGATE <br />S <br />x <br />i <br />WOIKeY COMPBNBATIONANO <br />9APLOYERP UAMUTY <br />EL EACH ACCIDENT <br />f <br />ELfMSEASEEA EMPLOtEE <br />0 <br />EL DISEASE - POLICY LMT Is <br />OTle11 <br />DEaCe"MW OPEMTON&LOCATKW4W VEHICLEMCWMONSADDM BY 810011891BRAPECIAL PROVISION <br />Certificate Holder added as Additional Insured by endoreenent to policy subjeat to the terns set <br />Earth in the endersesaent. SSJO dba 'Taller San Jose, Block Grant, 810 N. Poinsett&, Sant& Ana, CA <br />92701 <br />f[9Tx�IaaT!• „/�, nom„ <br />City of Banta ass, its officers, agents <br />cad mployea COMMUnitY Dewlop&ent Agency <br />20 Civic Center plaza <br />WO. 0425 - P.O. Boat 1960 <br />At”; Lucy Flores <br />Santa A., c& 92702 <br />78 Rpl:202105 <br />N OLAD ANYOFTHEABOVE OftMftE0 POLaI$ BE CANCELLED BEMW THE Ex%RATION <br />DATE THEREOF, THE MAIM IANURER MALL ENDEAVOR TO MAIL 30 DAY11 aaTTEN <br />NOTICE TO THE CEI RCATE HOLDER NAMED TO THE LEFT, V=a=M=EWesmmm{, <br />11"i <br />