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BLIND CHILDREN'S LEARNING 5 - 2004
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BLIND CHILDREN'S LEARNING 5 - 2004
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Last modified
10/15/2015 10:51:40 AM
Creation date
11/20/2004 1:56:25 PM
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Contracts
Company Name
Blind Children's Learning Center
Contract #
A-2004-087-05
Agency
Community Development
Council Approval Date
5/3/2004
Expiration Date
6/30/2005
Insurance Exp Date
10/16/2005
Destruction Year
2010
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CORP. CERTIFICATE OF LIABILITY INSURANCE <br />i0', /200 <br />PRODUCER (949) 709 -8800 FAX (949) 709 -1668 <br />Comprehensive Insurance Services <br />22342 Avenida Em resa <br />P <br />Suite 200 <br />RSM, CA 92688 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED B I i nd Ch dren' s Learning Center <br />18542 Vanderlip Avenue <br />Santa Ana, CA 92705 ^ r, 4'1_ <br />INSURERA: NONPROFITS' INSURANCE ALLIANCE <br />MUM, EFFECTNE <br />10/16/2004 <br />INSURER B: <br />LIMITS <br />I URER C: <br />SANTA ANA, CA 92701 <br />NSURER D: <br />GENERAL LIABILITY <br />NSURER E: <br />10/16/2005 <br />Well, <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 />INSR <br />R <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />MUM, EFFECTNE <br />10/16/2004 <br />POLICY EXPIRATION <br />ATE fuminnnY) <br />LIMITS <br /># i(**) dW6X11 (d4XiU€1N6Xdfwd'3"A W4 kwo (AR3KdSXfMMxXXXXXXX. <br />SANTA ANA, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />GENERAL LIABILITY <br />2004 - 00643 -NPO <br />10/16/2005 <br />EACH OCCURRENCE <br />$ 1,000,00 <br />X COMMERCIAL GENERAL LIABILITY <br />DAMAGE TO RENTED <br />SE <br />$ 100,000 <br />CLAIMS MADE a OCCUR <br />$ 10,000 <br />MED EXP (Any one pelwn) <br />A <br />PERSONAL B ADV INJURY <br />1,000,00C <br />GENERAL AGGREGATE <br />$ 1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />PRODUCTS - COMP /OPAGG <br />$ 1,000,00 <br />POLICY PRO- <br />JECT X LOG <br />AUTOMOBILE <br />LIABILITY <br />2004- 0064 3 -NPO <br />10/16/2004 <br />10/16/2005 <br />COMBINED SINGLE LIMIT <br />$ <br />X <br />ANY AUTO <br />(Ea amident) <br />1,000,000 <br />ALL OWNED AUTOS <br />BODILY INJURY <br />$ <br />A <br />SCHEDULED AUTOS <br />(Per person) <br />HIRED AUTOS <br />i. - r -. <br />BODILY INJURY <br />$ <br />NON -OWNED AUTOS <br />- <br />(Perac dent) <br />PROPERTY DAMAGE <br />$ <br />7 <br />(Per.Wdent) <br />GARAGE LIABILITY <br />'` <br />- <br />AUTO ONLY - EA ACCIDENT <br />$ <br />ANY AUTO <br />OTHER THAN EA ACC <br />$ <br />AUTO ONLY ASS <br />$ <br />EXCESS/UMBRELLA LIABILITY <br />2004- 00643 - LIMB -NPO <br />10/16/2004 <br />10/16/2005 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />X OCCUR CLAIMS MADE <br />AGGREGATE <br />$ <br />A <br />2,000,000 <br />$ 2,000,00 <br />DEDUCTIBLE <br />8 <br />RETENTION $ <br />$ <br />WORKERS COMPENSATION AND <br />WG STATU- OTH- <br />LIM TS <br />EMPLOYERS' LIABILITY <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER /MEMBER EXCLUDED? <br />EL DISEASE - EA EMPLOYE <br />$ <br />I( yes, describe antler <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />SPECIAL PROVISIONS below <br />SERVICES <br />2004 - 00643 -NPO <br />10/16/2004 <br />10/16/2005 <br />$1,000,000 AGGREGATE LIMIT <br />ISUML <br />A <br />PROFESSIONAL LIABILITY <br />$1,000M,0OO EACH OCCURRENCE <br />ERTIFIICATEPHOLDERLIS <br />NAMEDHASBADDITIONAL INSURED$PERTATTACHED CITY ENDORSEMENT EXHIBIT B <br />*EXCEPT 10 DAYS FOR NON- PAYMENT <br />CCKI IHICAI HOLDER rwurcr, w <br />LO(ZUUIIUU) rMA. k714;647 -6549 <br />©ACORD CORPORATION 1988 <br />V <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL I X4Wt)j MAIL <br />CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, <br />*30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT <br />AGENTS, VOLUNTEERS AND REPRESENTATIVES <br />X )wgww6V& xftw4H&hLxMXX. <br />20 CIVIC CENTER PLAZA <br /># i(**) dW6X11 (d4XiU€1N6Xdfwd'3"A W4 kwo (AR3KdSXfMMxXXXXXXX. <br />SANTA ANA, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />Richard r_ , CIC /KRISTY <br />LO(ZUUIIUU) rMA. k714;647 -6549 <br />©ACORD CORPORATION 1988 <br />
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