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Client#: 1'" CATHOPA <br />ACORD. CERTIFIC ABILITY S NCE1 09129103 <br />DATE(MMI D ) <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Arthur J. Gallagher 8r Co. Ins. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Brokers of CA Inc Lic.#0726293 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />One Market Spear Twr Ste 200 <br />San Francisco, CA 94105 INSURERS AFFORDING COVERAGE NAIC 0 <br />INSURED INSURER A; The Ordinary Mutual, a R.R.G.C. 10171 <br />Raman Catholic Bishop of Orange INSURER B; Phoenix Assurance Company of New Yo 35262 <br />P.O. Box 14195 INSURER c Allianz Insurance Company 35300 <br />Orange, CA 92863-1595 /� INSURER D: <br />,-zoo3 — 158 INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, 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 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 />LTR <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />Y EFFECTIVE <br />DA /YY <br />POLICY EXPIRATION <br />DATE M !YY <br />LIMITS <br />A <br />GENERAL L ABKJTY <br />CGAL0042003 <br />07101/03 <br />07/01104 <br />EACH OCCURRENCE $1.000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE a OCCUR <br />DAMAGES (RENTED $50,000 <br />MED EXP (Any one person) $5.000 <br />PERSONAL d ADV INJURY $1.000,000 <br />GENERAL AGGREGATE s2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS- COMPIOP AGG S2,000,000 <br />POLICY PRO-JECT F� LOC <br />A <br />AUTOMOBILE LJABIUTY <br />X ANY AUTO <br />CGAL0042003 <br />07101/03 <br />07/01/04 <br />(Ea aaWdent) INGLE LIMIT $1,000,000 <br />BODILY INJURY $ <br />(Per person) <br />ALLOWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />BODILY INJURY $ <br />(Per accident) <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT S <br />OTHER THAN EA ACC $ <br />ANY AUTO <br />AUTO ONLY: AGG S <br />EXCI:SSNM5RELLA LIABILITY <br />OCCUR FICLAIMS MADE <br />EACH OCCURRENCE S <br />AGGREGATE S <br />S <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />B <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />CIA10021703 <br />11113/02 <br />11/13/03 <br />X WOC STATu- ER <br />IjMIT <br />E.L. EACH ACCIDENT $1,000,000 <br />ANY PROPRIETOR/PARTHERJEXECUT7VE <br />OFFICERIMEMBEREXCLUDED? <br />KPEIALPROYISI N5 below describe under <br />S <br />E.L. DISEASE - EA EMPLOYEd $1,000,000 <br />E.L. DISEASE - POLICY LIMIT S1.000, 000 <br />C <br />OTIHER Commercial <br />CLP3003555 <br />07101103 <br />07/01/04 <br />$250,000 <br />Property <br />F {" <br />- � •••• •• •-r••^ ••�•���• �..� ..wawwa AV4cu or �VUHStMRnlf+u'CG:IAL YKpY1S1ONH <br />Re: Catholic Charities of Orange County, 1800 E. McFadden, Santa Ana, <br />CA 92705 as respects Empowerment Zone Contract. The City of Santa Ana, <br />Its officers, employees, agents and representatives are named as additional <br />Insureds per Attachment F. <br />Clerk of the City Council <br />City of Santa Ana <br />20 Civic Center Plaza (M-30) <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />11;�;1�Itci <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL EMIL 3f1. DAY$ WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 8 <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2001108) 1 of 2 #S1121851M107679 15CS ® ACORD CORPORATION 1909 <br />