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FROM <br />Jul 29 04 01:58p <br />FAX NO. : <br />ACORD TM. CERTIFICATE OF LIAE <br />Fa RORR <br />BAKER OMERO d ASSOCIATES INSURANCE GROKGRS, INC. <br />770 TERRADO PLAZA 0238 <br />COVINA CA 91729 <br />PHONE; 928.9328269 <br />AX: -921 AyIBncY ucJ: 0739340 <br />929�939 _. .......:._— <br />INSURED <br />COUNCIL ON AGING OF ORANGE COUNTY <br />4971 E. ATH ST. SUITE 200 <br />SANTAANA CA 92705.3917 <br />Aug. 18 2004 07:50AM P2 <br />IS <br />INSURERS AFFORDING COVERAGE <br />p.13 <br />DATE (MW4DONY) <br />_ JUL2404 <br />MATTER OF INFORMATION <br />PON THE CERIFICATE <br />NOT AMEND. EXTEND OR <br />BY Tw POLICIES M9LOW. <br />NAIC N <br />THE POLICIES OF INSURANCE UBTEO BELOW HAVE BEEN EBYm TO THE INSURED NAMED ABOVE FOR THS POLICYPERIDD INDICATED. NOTWITHSTANDING <br />ANY REDUIREMNT, TERM OR CONMRION OF ANY CONTRACT OR OTHER OOCUAFNT WITH RESPECT TD WIMCN THIS G,R FICAT% NAY BE NISUEO OR <br />MAY PERTAIN. THE NSIRANOE AFFOROEO BY TONE POLICIES OEEORMFD HMiEN IS BUBJECT TO ALL7HE TERMSL EXCLUSIONS AND CowomONS OF SNA1 <br />POUDMA. AGGREGATE LMIM KNOWN MAY RAVE BEEN REDLNMD BY PAID CLAIMS. <br />LVI <br />TYPEOFNBURANOE <br />I POLNW NIISMML' <br />PO111N1 CP6nYE <br />POUINWMMATMN <br />LIMITS <br />OMMEwM <br />UAmLNY <br />PNPKOK4541 <br />JUL 104 <br />JUL I O$ <br />EACHOCOUNW410E <br />f _ 11000,000 <br />A <br />X <br />COMMp1CIAL GENERAL WIBILRY <br />. 1 CAMISNADE rX] OCCUR <br />i <br />�n,N�n.i.p <br />. EXP(Any Om Pa) ..... <br />MWepA <br />PUMDAAL A ADV IWURY <br />E 200.000 <br />9 0000 <br />N 1000,000 <br />GENERALAGGFWQATE <br />f 2.000.000 <br />GEML ADDREpATE UMIr APPLIESFER: <br />5 .. 1.000,000 <br />PRODUCTBCOM P" AGG.... <br />AUTOMOSULIABIUTY <br />ANY AUTO <br />PHPKOK45V1 <br />JUL 104 <br />JUL 105 <br />COMMNEOSINGLEUAIT <br />IBM SIORMN) <br />j D <br />' ALL OWIMFn AUT09 <br />IbINLY YMURY <br />_ ....— <br />A <br />SCHEbuLBDAUMS <br />Da Siow) <br />_.... <br />S <br />X HIREMAUTOS <br />^X MONOWNWAUT09 <br />, <br />BODILYINJURYS <br />_... <br />Vc= <br />/1-3 <br />.... <br />_.... ._._..._— <br />PROKnjY DAMAGE <br />M <br />GARAGE LIAMT.RI' <br />AUTO DILY-FP ACCIDENT <br />S <br />ANY A DL/ <br />OTHIR kARUG <br />5 <br />AUTDONLY <br />AUrOONLY: <br />AGOI <br />j ...._._ <br />ETeESe 11MSMpp1A LMSILRY <br />JOCCUR L CLAMP MADE <br />PHUE021T77 <br />JUL 104 <br />JUL 106 <br />BM;HOCCURRENCE <br />S 2,000,000 <br />SIN _;, <br />-- 0 <br />F <br />DEDUCrMLE <br />___... _ ._— <br />j <br />RETENTION j <br />WORKERS COMPENSATION AND <br />EMPLOYER, LIABLRT <br />WEaTAT14 Omtl. <br />F,I_ FACH ACCIDENT <br />S <br />ANY NASmETORPAMMNMIRISCumE <br />FRFI®IMAMYR WCLIeMR <br />RPN MNMM MN, <br />MAfALL AIPMBIOMP WIw <br />E.L. OMEAS&EA EMPLOYEE <br />S <br />E.L. OISEADEPOLICY LINT <br />.._..._._ <br />f <br />A <br />OTHM PROFES810NAL LIABILITY <br />g1PKOK"41 <br />JUL 104 <br />705RANCE <br />-$I.N%000 <br />AGGREGATE - $2,000.000 <br />DESCRIPTION OF OPERATIONSILOCATIONNENICLPRMXCLUSIONS ADDED ENDOR' HENT/ SPECIAL PROVNOJONB <br />SEE SUPPLEMENTAL CERTIFICATE INFORMATION <br />CITY OF <br />AGENCY 9425 <br />SANTA ANA, CA 92702-1998 r7g� <br />NS <br />Attention; JOHN P. MALONEY, MANAGEMENT AID 0) ,yv- j&%'SWV- <br />ArORD 25 (200IMS) Ce66m)e 111 1855 LIIIInnRaiwro Gomez 06945. <br />