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<br />ACORD,. CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDfYY) <br />2/11/05 <br />PRODUCER 205.701-5000 THIS CERTIFICATE IS ISSUED AS A MAHER OF INFORMATION <br /> Acordia ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> CA License # 0531007 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> P.O. Box 91143 <br /> Seattle, WA 98111-9774 INSURERS AFFORDING COVERAGE <br />INSURED ,4 r -{%fo First National Ins. CO. <br /> AIDS Housing of Washington ~I INSURER A: <br /> 2014 East Madison St, Ste 200 INSURER B: <br /> Seattle WA 9B122 INSURER c: <br /> INSURER D: <br /> INSURER E: <br /> <br />COVERAGES <br /> <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 />I~f: TYPE OF INSURANCE POLICY NUMBER POLICY EFFE~T!.~~ P~k!fEY,~~I~~TJe~ LIMITS <br />A ~NERAL LIABILITY 25CC04149020 1/02/05 1/02/05 EACH OCCURRENCE $ 1000000 <br /> X ' COMMERCIAL GENEFltl,L LIABILITY I FIRE DAMAGE (Anyone fire) $ 200000 <br /> __JCLAIMS MADE W OCCUR MEDEXP IAny one personl , <br /> r----- -- 10000 <br /> ~ STOP GAP $1 M/$1 M/$1 M PERSONAL & ADV INJURY $ 1000000 <br /> I --. <br /> 1<J EMPL Y BEN EMPLOYEE BENEFITS I GENERAL AGGREGATE $ 3000000 <br /> -~ <br /> I~'L AGGREn LIMIT A74 PER: LIABILITY LIMIT: PRODUCTS - COMP/oP AGG $ 1000000 <br /> POLICY ~~9T LOC . <br /> 3 000 000 AGG. <br />A ~,:!TOMOBILE LIABILITY 25CC04149020 1/02/05 1/02/06 COMBINED SINGLE LIMIT <br /> lEa accident) $ 1000000 <br /> r----- ANY AUTO <br /> ALL OWNED AUTOS BODILY INJURY <br /> r----- (Per person) $ <br /> r----- SCHEDULED AUTOS <br /> -- HIRED AUTOS BODilY INJURY <br /> (Peraccidellt) , <br /> .lS.. NON-OWNED AUTOS <br /> .lS.. BUSINESS PROPERTY DAMAGE <br /> (Per accident) , <br /> AUTO <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> R ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY' AGG , <br /> EXCESS LIABILITY 'l.PPROVt. .J AS TO [ ORM EACH OCCURRENCE , <br /> ~ OCCUR D CLAIMS MADE AGGREGATE , <br /> '/1A, O;{i/ / Ie; <br /> '_ /I.......L , <br /> ~ ~EOUCTIBLE $ <br /> RETENTION $ ;' l...aUr Stftt Sheedy , <br /> WORKERS COMPENSATION AND i-,.~:::.Jsta [ City Attorn y ~~c STATU-, I IOTH- <br /> TORY LIMITS ER <br /> EMPLOYERS' LIABILITY I <br /> f:'.L. EACH ACCIDENT $ <br /> - <br /> E.L. DISEASE - EA EMPLOYEE $ -- <br /> - <br /> E.L. DISEASE - POLICY LIMIT $ <br /> OTHER <br />DESCRIPTION OF OPERATIONSfLOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> SEE ATTACHED FOR SPECIFIC WORDING REGARDING ADDITIONAL INSURED <br /> INTEREST. JHWL <br />CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION <br /> City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN <br /> Attn: Clerk of City Council NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> PO Box 1988 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> Santa Ana CA 92702-1988 RE~TATIVES. <br /> AUTHOR~RESEN~(!E~) <br /> I ,'c...k. ylt,\ <br /> . '--' <br /> <br />ACORD 25 S 17/97) <br /> <br />11.38 <br /> <br />@ ACORD CORPORATION 19BB <br />