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n GtK 111-1UA i t UI' LIAWLI I Y INSUKAN_ut 12j11/2003' <br />PRODUCER (949) 553-9700 FAX i53-9797 THIS CERTIFICATk TED -AS A MATTER OF INFORMATION <br />Westland Insurance Brokers ONLY AND CONFENa N. RIGHTS UPON THE CERTIFICATE <br />2192 Martin Street, Suite 130 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Irvine, CA 92612 <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURED Delhi Community Center INSURERA: TRAVELERS PROPERTY CAS INS CO 36361 <br />505 South Central Ave. INSURERB: Carolina Casualty Insurance Co <br />Santa Ana, CA 92707-3504 INSURER C: <br />INSUNSURER D: <br />RER E: <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 />INSRDD' <br />TypE OF INSURANCE is <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />GENERAL LIABILITY <br />660818X4872-03 <br />12/14/2003 <br />12/14/2004 <br />EACH OCCURRENCE $ 1,000,000 <br />COMMERCIAL GENERAL LIABILITY <br />XI <br />DAMAGE TO RENTED S 100,000 <br />CLAIMS MADE j OCCUR <br />MED EXP (Any one person) $ 5, OD <br />A <br />I <br />PERSONAL&ADV INJURY $ 1,000,00 <br />GENERAL AGGREGATE $ 2,000,00 <br />GENT AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGO $ 2,000,00 <br />POLICY jE Q LOC <br />AUTOMOBILE <br />LIABILITY <br />8103123W685-03 <br />12/14/2003 <br />12/14/2004 <br />COMBINED SINGLE LIMIT <br />$ <br />ANY AUTO <br />(Ea accident) <br />1,000,000 <br />BODILY INJURY <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />(Per person) $ <br />A <br />X <br />HIRED AUTOS <br />BODILY INJURY $ <br />X <br />NON -OWNED AUTOS <br />(Per accident) <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />ANY AUTO <br />OTHER THAN EA ACC $ <br />AUTO ONLY: AGG $ <br />EXCESSAIMBRELLALIABILITY <br />CUP 3289W520-03 <br />12/14/2003 <br />12/14/2004 <br />EACH OCCURRENCE $ 1,000,000 <br />X OCCUR O CLAIMS MADE <br />AGGREGATE $ 1,000,000 <br />A <br />APPROVED <br />AS "SOP <br />RM <br />Retained <br />Limit $ 10,0 <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />Y2 <br />1 $ <br />WORKERS COMPENSATION AND <br />La a <br />3titt SheCdy <br />WCSTATU- OTH- <br />I <br />EMPLOYERS' LIABILITY <br />E.L. EACH ACCIDENT $ <br />ANY PROPRIETOWARTNERIEXECUTIVE <br />Assistant <br />City Attorney <br />OFFICER/MEMBER EXCLUDED? <br />E. L. DISEASE - EA EMPLOYE1i <br />yes, dL antler <br />E.L. DISEASE -POLICY LIMIT $ <br />S PROVISIONS PROVISIONS below <br />OTHER <br />Trectors &Officers <br />3336857 <br />01/14/2003 <br />01/14/2004 <br />$1,000,000 Per Claim/Aggregate <br />B <br />$1,000 Deductible <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />City of Santa Ana, Community Development Agency M-25 are named as Additional Insureds <br />s per endorsements CN0188(01/9) ,CGDO37(0199) & Exhibit B attached with respects to the <br />operation of the Named Insured. <br />Except 10 days for Non-payment of Premium. <br />City of Santa Ana <br />Community Development Agency M-25 <br />Carla Thompkines <br />P.O. Box 1988 <br />Santa Ana, CA 92707-1988 <br />ACORD 25(2001/08) rya: Ly iv�owy-DOyy <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL K400(VJM MAIL <br />"30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />AUTHORIZED <br />©ACORD CORPORATION 1988 <br />