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BOYS AND GIRLS CLUB 4B -2003
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READY TO DESTROY PRIOR TO 2017
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BOYS AND GIRLS CLUB 4B -2003
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Entry Properties
Last modified
4/8/2020 8:45:10 AM
Creation date
1/20/2004 2:06:23 PM
Metadata
Fields
Template:
Contracts
Company Name
Boys and Girls Club of Santa Ana
Contract #
A-2003-228
Agency
Community Development
Council Approval Date
11/17/2003
Expiration Date
9/30/2005
Insurance Exp Date
1/5/2005
Destruction Year
2010
Notes
Amends A-2001-197, A-2001-197A Amended by A-2004-197
Document Relationships
BOYS AND GIRLS CLUB 4 -2001
(Amends)
Path:
\Contracts / Agreements\_PENDING FOLDER\READY TO DESTROY PRIOR TO 2017
BOYS AND GIRLS CLUB 4A - 2002
(Amends)
Path:
\Contracts / Agreements\_PENDING FOLDER\READY TO DESTROY PRIOR TO 2017
BOYS AND GIRLS CLUB 4C - 2004
(Amended By)
Path:
\Contracts / Agreements\_PENDING FOLDER\READY TO DESTROY PRIOR TO 2017
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DATE {MMIDDIYYYY) <br /> COI DM CERTIFICATE OF LIABILITY INSURANCE 1 /31/2003 <br />PRODUCER (909) 587-2719 FAX (909) 587-6001 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Anthem Tnsurance ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />42145 Lyndie Ln., #202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, <br />Temecula, CA 92591 <br />License # OB84551 INSURERS AFFORDING COVERAGE ~AIC# <br />INSURED BOyS and Girls Club-of Santa Aha ~NSURERA Narkel Tnsurance Company <br />950 Highland St INSURER B <br />Santa Rna, CA 92703 INSURERC: <br /> INSURER D: <br /> INSURER E <br /> <br />COVERAGES <br /> <br /> THE POLICIES OF INSUP~NCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN, <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 /> <br />INSR ~DD'[ POLICY EFFECTIVE POLICY EXPIRATION <br />LTR NSR[ TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDIYY} DATE IMMI~3DIyy) LIMrTS <br /> GENERAL LIABILITY 8502CY073003 12/20/2003 01/05/2005 EACH OCCURRENCE $ 1,000,000 <br /> .COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50 ~ 00(~ <br /> -- ~ CLA~MSMADE [] OCCURi MEDEXP(Anyo.eper$on) $ 5~00(] <br /> A X PERSONAL & ADV INJURY $ ~, 000,000 <br /> G~NERAL AGGREGATE $ 3 , 000,000 <br /> GEN'L AGGREGATE UMIT APPLIES PER: PRODUCTS COMPlOP AGG $ I ~000,O0~ <br /> AUTOMOBILELIABIL~TY 1002CYC0730044 12/20/2003 01/05/2005 COMBINED S[NGLE LIMIT <br /> ~ ANY AUTO (Da accident) $ ~ , O00,000 <br /> <br /> EXCESSIUMBRELLALIABILI~ 4602CY0730105 12/20/2003 01/05/2005 EACH OCCURRENCE $ 5,000,00~ <br /> ~ OCCUR ~ CLAIMS MADE AGGREGATE $ - 51000,00~ <br /> A X ~ <br /> <br /> WORKERS COMPENSATION AND . ;~;~*;;,;~ _r~ ~ <br /> y cancel non : "' <br /> ~ay~nt o¢ p~em~um <br /> <br />DESCRIPTION OF OPE~TIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />~E: C~ty of Santa Aha, ~ts officer, agents and employees are na~d as additional ~nsured <br />~s ~espects the operations of the na~d ~nsured. <br /> <br />CERTIFICATE HOLDER <br /> <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br /> <br />ACORD 25 (2001108) <br /> <br />CANCELLATION <br /> SHOULD ANY OF THE A~BOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ~X~ MAIL <br /> 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> <br />©ACORD CORPORATION i988 <br /> <br /> <br />
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