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<br />------- <br />---.-- ------ --------- ---- <br />--- _.._~...~--- <br />I~ACORD- - CERTIFICATE OF LIABILITY INSURANCE AIg~W-F DAT~~7;~~~Y~1 <br />P DU",", THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO <br />r/ .K ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />sswood Insurance Agency, Ltd. ~P}~~~H1H~~~~Iil~~C:~~g~EESD NB~\~~Ep~LI~fJSE~~L~~ <br />340 South Farrell Dr1ve A203 <br />Palm Springs CA 92262 I <br />phone: 760-322-4466 INSURERS AFFORDING COVERAGE ~._-,! NAIC # <br />INSUR-~---'--- --- -------------. '-----'----------;¡-"-l-~~SURE~--~on -;rof:it:-~~CeAl.~iance I - <br />A - a..oor -De~ IINSURO::~B -Non-Prof"its .unit:a,----¿-------i-- <br />A.S. Found. Orange Cnty d/bþa I~-URER-C --------_.._-_u,--- <br />~~~Š2 W~~~ ~~r~rgîr;;ï~Y ste AJ ~NSU~~;;-;;--'----- <br />Irvine CA 92614-6408 I-~.----- --~ ~ <br />J INSURER E <br /> <br />=r~~ <br /> <br />----.. <br /> <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE JNSUHED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. N01WITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />f,AAy 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 />~- POLICY EFFECTIVE POLICY EXPlRATIO <br />TYPE OF INSURANCE POLICY NUMBER DATE MM/DONY DATE MMlDDIYY <br />GENERAL LIABILITY <br /> <br />-----..- <br /> <br />LIMITS <br /> <br />L TR NSR <br /> <br />GENERAL AGGREGATE <br />PRODUCTS - COMPfOP AGG <br /> <br />, 1,,000,000 <br />$ 100,000 _..- <br />, 10,00~- <br />$ 1 ~-Q~)Q , Oo~- <br />$ 3 .,-goo, 00°_- <br />'3,000,00°_- <br /> <br /> <br />X COMMERCIAL Gt::NERAL LIABILITY <br />- ] CLAIMS MADE [!] OCCUR <br />X Misc Prof Liab I <br /> <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />j j~g <br />AUTOMOBILE LIABILITY <br />X ANY AUTO <br /> <br />2003-08363-NPO <br /> <br />07/29/03 <br /> <br />07/29/04 <br /> <br />EACH OCCURRENCE <br />~ <br />I PREMISES (Ea QCcurence) <br /> <br />, MED EXP (Anyone person) <br /> <br />PERSONAL & ADV INJURY <br /> <br />AIX <br /> <br />lOG <br /> <br />B <br /> <br />MEMBER 0748/POOL <br /> <br />07/01/03 <br /> <br />07/01/04 <br /> <br />COMBINED SINGLE LIMIT <br />(Eaaccident) <br /> <br />s 1,000,000 <br /> <br />~=-=- <br /> <br />I $ <br />..j_.~-----_. <br />I <br />is <br /> <br />, <br /> <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br /> <br />BODILY INJURY <br />(Per person) <br /> <br />X HIRED AUTOS <br />X I NON-OWNED AUTOS <br />-'-j <br /> <br />BODILY INJURY <br />(Peraccident¡ <br /> <br />I PROPERTY DAMAGE <br />, (Per accident) <br /> <br />GARAGE LIABILITY <br />ANY AUTO <br /> <br />AUTO ONLY - EA ACCIDENT ¡ S <br /> <br />OTHER THAN <br />AUTO ONLY <br /> <br />EAACC: S <br />--------r--- - <br />AGG ! S <br /> <br />-------- <br /> <br />Ai <br /> <br />EXCESS/UMBRELLA LIABILITY <br />OCCUR n CLAIMS MADE <br />~ <br /> <br />2003-08363-UMB-NPO <br /> <br />07/29/03 I <br />, <br />, <br /> <br />07/29/04 <br /> <br />EACH OCCURRENCE I $ 2,000, DOC <br />AGGREGATE ---0-2/.9°0, O.Q.Q= <br />, <br /> <br />--_.--- <br /> <br />~ DEDUCTIBLE <br />X RETENTION s10,000 <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />ANY PROPR\ETORfPARTNERfEXECUTIVE <br />OFFICER/MEMBER EXCi..UDED? <br />~pÊtI1~~~'õvÏs1öNS below <br />OTHER <br /> <br /> <br /> <br />, <br />, <br /> <br />I ER <br /> <br />, <br /> <br />_.------- <br /> <br />E.L- DISEASE - EA EMPLOYE $ <br />E.L DISEASE - POLICY LIMIT $ <br /> <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />Certificate Holder is named as Additional Insu:l:'ed, per attached endorsement. <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />SANTAA1 <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAT <br />DATE THEREOF, THE ISSUING INSURER WILL CIJBE.,. 8 IX! Tg MAIL ~ DAYSWRITTE <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, B'C I r,...u...~RE! T'" "'n ~'" ~'ILt <br /> <br />City of Santa Ana <br />Housing Authroity <br />PO Box 22030 <br />Santa Ana CA 92702 <br /> <br />(M-27) <br /> <br />~~-+ÐNQRb.'An" T'sr.IJ. HIrIBI::IP6r~TIIEIIJ3URLR,IT.3ASE:IH.:IõJ1: <br /> <br />~tJTAT"'<::" <br /> <br />AUT <br /> <br />IZ <br /> <br />REP~T <br /> <br />. <br /> <br />{ f!.;e. I <br /> <br />ífU4?le-Jc./ <br /> <br />ACORD 25 (2001/08) <br /> <br />@ ACORD CORPORA TIO <br />