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ACORD. CERTIFICA fE OF LIABILITY INSURANCE DATE PRODUCER (849)709 -8800 FAX (949)709 -1668 Comprehensive Insurance Services 22342 Avenida Empresa Suite 200 RSM, CA 92688 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Camp F ire USA - Orange County Counc i I 14742 Plaza Drive, Ste 205 Tustin, CA 92780 INSURERA MARKEL INSURANCE COMPANY COMMUNITY DEVELOPMENT AGENCY INSURER B: GENERAL LIABILITY NSURER C: 07/12 /2004 INSURER D: EACH OCCURRENCE INSURER E: DAMAGE TO RENTED L. V V CKA"CJ THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGR GATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS COMMUNITY DEVELOPMENT AGENCY GENERAL LIABILITY 8502CY243262 -2 07/12 /2004 07/12/2005 EACH OCCURRENCE $_1,000,0 DAMAGE TO RENTED $ 100 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one Parson) $ 5 , OO CLAIMS MADE FV 1 OCCUR PERSONAL 8 ADV INJURY $ 1,000,000 A GENERAL AGGREGATE $ 3,000,00 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 3,000,000 POLICY I I JE7 LOG AUTOMOBILE "ABILITY ANY AUTO 1002CY243263 -2 07/12/2004 07/12/2005 COMBINED SINGLE LIMIT (Ea accident) $ 1 .000 , 0 X BODILY INJURY (Per Person) $ A ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTUS BODILY INJURY (Per acwent) $ PROPERTY DAMAGE (Per accident) $ LIABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EA ACC $ AUTO r!�D-E $ AUTO ONLY: AGG EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE $ $ DEDUCTIBLE $ RETENTION $ WC STATIT O WORKERS COMPENSATION AND R EL EACH ACCIDENT $ EMPLOYERS' LIANUTY IETORIPARTNER/EXECUTE ANY PROPR N OFFICERIMEMBER EXCLUDED? �-- E.L. DISEASE -EA EMPLOYEE S IT Yes, descnlae Vide! SPECIAL PROVISIONS belay E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS ITY OF SANTA ANA, IT'S OFFIERS, AGENTS,EPLOYESS AND VOLUNTEERS ARE NAMED ADDITIONAL INSURED ER ATTACHED CG2026 10 DAY CANCELLATION NOTICE FOR NON PAYMENT OF PREMIUM CERTIFICATE HOLDER CANCELLATION ACORD 25 (2001/08) © ACORD CORPORATION 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL X14 MAIL *30 GAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. CITY OF SANTA ANA - CDBG M -25 dfi? rXaC1!> i06XXIXXJ€ 1id61il@ fllfi4XXMAli��4iWb6 (�yXXi(d4�YXX: COMMUNITY DEVELOPMENT AGENCY PO BOX 1988 M -25 a";LU)O)(W)CXAM xlx M)WWJ WxarlXXs mxXXXXXXX: AUTHORUED REPRESENTATIVE /Z SANTA ANA, CA 92702 Richard Eynon, CIC /KRISTY ACORD 25 (2001/08) © ACORD CORPORATION 1988