Laserfiche WebLink
4IF SUN CERTIFICATE OF LIA131LI f Y MUKANUL izji jzoo3 <br />PRODUCER (949) SS3-9700 FAX (949)553-9797 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Westland Insurance Brokers ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />2192 Martin Street, Suite 130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Irvine, CA 92612 <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURED Delhi Commnunity Center INSURERA: TRAVELERS PROPERTY CAS INS CO 36361 <br />505 South Central Ave. p`-a�`� ���� INSURERS: Carolina Casualty Insurance Co <br />Santa Ana, CA 92707-3504 INSURER C: <br />INSURER D: <br />INSURER E: <br />CFTVFRAr.FSQ <br />THE POLICIES OF INSURANCE 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 />IN$RbD' <br />TP <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATIONI <br />LIMITS <br />GENERAL LIABILITY <br />660818X4872-03 <br />12/14/2003 <br />12/14/2004 <br />EACH OCCURRENCE S 1,000,0()1 <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE O OCCUR <br />DAMAGE TO RENTED I S LOO , OOI <br />MED EXP (Any one pereon) 3 S,004 <br />PERSONAL & ADV INJURY $ 1,000,001 <br />A <br />GENERAL AGGREGATE 3 21000,004 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO- LOG <br />JECT <br />PRODUCTS - COMPIOP AGG S 2.000,004 <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />8103123W685-03 <br />12/14/2003 <br />12/14/2004 <br />COMBINED SINGLE LIMIT <br />(Ea accident) 1,000,00 1,000,001 <br />BODILY INJURY 3 <br />(Per perew) <br />A <br />X <br />X <br />ALL OWNED AUTOS <br />SCHEDULEDAUTOS <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />BODILY INJURY <br />(Per accident) 3 <br />PROPERTY DAMAGE S <br />(Par accldenl) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />ANY AUTO <br />OTHER THAN EA AGC $ <br />AUTO ONLY: AGG S <br />A <br />EXCESSIUMBRELLALIABILITY <br />X OCCUR O CLAIMS MADE <br />CUP 328914520-03-T2724/2003 <br />- <br />a; -PIS J <br />. _ _ . <br />12/14/2004 <br />. , ., <br />:�` > <br />EACH OCCURRENCE 3 1100-0,00( <br />AGGREGATE $ 1,000,00( <br />Retained Limit s 10,00( <br />DEDUCTIBLE <br />4 <br />RETENTION S <br />3 <br />WORKERS COMPFNSA71ON AND <br />EMPLOYERW LIABILnY <br />ANY PRppRIETOR/PARTNER/EXECInNE`!�' <br />OFFICERIM EMBER EXCLUUED7 <br />If yes, deatribe under <br />i -,� LI <br />y - - <br />1^rC STATU- QTH- <br />E.L. EACH ACCIDENT S <br />E.L. DISEASE • EA EMPLOYEq 3 <br />EL DISEASE -POLICY LIM IT 1 3 <br />SPECIAL FROM SIONS below <br />B <br />°TfEII3336857 <br />-hectors & Officers <br />01/14/2003 <br />01/14/2004 <br />;1,000,000 Per Claim/Aggregate <br />$1,000 Deductible <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES <br />Y16- a Hnlifv Ri.A. Tn Allnnneulonn <br />I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECU%PROVISIONS <br />I,, 11,n_1 <br />Santa Ana Empowerment Corporation and the City of Santa Ana are named as Additional Insured's <br />per attached GN0188 (0196) and CGD037 (0199) <br />non-payment of premium which is a 10 day notice of cancellation <br />Santa Ana Work Center <br />Laura <br />1000 E. Santa Ana Blvd <br />Suite 200 <br />Santa Ana, CA 92781 <br />ACORD 25 (2001/08) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL VIYXXlxiM MAIL <br />n30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />�'��xx�u�cxxaccxa(xlra�€xxxxnla�mlx�L>vx�xxxxx <br />AUTHORIZED <br />©ACORD CORPORATION 1981 <br />