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<br />I CERTIFICA TE OF LIABILITY INSURANCE I DATE (MM/DDNYYY) <br />~'ACORD. 06/25/2004 <br /> . '" <br /> PROOUCER (949)553-9700 FAX (949)553-9797 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Westland Insurance Brokers ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 2192 Martin Street, Sui te 130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Irvine, CA 92612 <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED Oelhi (ommnunlty Center INSURER A TRAVELERS PROPERTY CAS INS CO 36361 <br /> 505 South Central Ave. INSURER B Carolina Casualty Insurance Co <br /> Santa Ana, CA 92707-3504 INSURER C "REVISED 6/25/04 RENEWAL OF <br /> INSURER D CRIME COVERAGE 7/7/04-05 <br /> INSURER E: NO OTHER CHANGES OR ENDTS ATTD <br /> COVERAGES <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 /> INSR 00' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPJRA TlON LIMITS <br /> GENERAL LIABILITY 660818X4872-03 12/14/2003 12/14/2004 EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100, 000 <br /> I CLAJMS MADE 0 OCCUR MED EXP (Anyone person) $ 5,000 <br /> A PERSONAL & ADV INJURY $ 1,000,000 <br /> - GENERAL AGGREGATE $ 2,000,00( <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 <br /> "I UPRO n <br /> POLICY JECT LOC <br /> AUTOMOBILE LIABILITY 8103123W685-03 12/14/2003 12/14/2004 COMBINED SINGLE LIMIT <br /> - ANY AUTO (Eaaccident) $ l,OOO,OOC <br /> - ALL OWNED AUTOS <br /> BODILY INJURY <br /> - (Per person) $ <br /> SCHEDULED AUTOS <br /> A X <br /> HIRED AUTOS BODILY INJURY <br /> X (Per accident) $ <br /> NON-OWNED AUTOS <br /> I- )/fJl.1~'/ <br /> r- ./ Ji5 PROPERTY DAMAGE $ <br /> (Per accident} <br /> GARAGE LIABILITY V -/"- AUTO ONLY - EA ACCIDENT $ <br /> B ANY AUTO // EA ACC $ <br /> OTHER THAN <br /> AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY CUP 3289W'520-03 12/14/2003 12/14/2004 EACH OCCURRENCE $ 1,000,000 <br /> :KJ OCCUR D CLAIMS MADE AGGREGATE $ 1,000,000 <br /> A Retained Limit $ lO,OOC <br /> ~ OEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND I WC STATU- 10TH- <br /> EMPLOYERS' LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? E,L DISEASE - EA EMPLOYEE $ <br /> If yes, describe under <br /> SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT $ <br /> OTHER 3336857-2 01/14/2004 01/14/2005 $1,000,000 Per Claim/Aggregate <br /> B p,rectors & Officers $1,000 Deductible <br />FiESCRJPTlON OF OPERATIONS' LOCATIONS 'VEHICLES' EXCLUSIONS ADDED BY ENDORSEMENT' SPECIAL PROVISIONS <br /> idelity Bond: The Hartford #72BDDAM2830 - 7/7/2004-2005 Limit: $600,000 Deductible: $2,500 <br />~he Santa Ana Empowerment Corporation and the City of Santa Ana are named as Additional Insured's <br />~s per attached GN0188 (0196) and CGD037 (0199) <br /> 'Except non-payment of premium which is a 10 day notice of cancellation <br /> <br />L <br /> <br />C L <br />SHOULD ANY OF THE ABOVE DESCRIBED POllCJES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WfLL~~ MAIL <br />"'~ 3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />1CJXJJOOOI~1()(iI(~ 1(lOO(1II11160~XX <br />1OOOOl<lOOl>>1lK_I(ol(,JiICilO!JI lllilllll iIllDOO6lOO(XXXXXXX <br />AUTHORIZED REPRESENTATIVE l <br />~fr' <br />@ACORDCORPORATION1988 <br /> <br /> <br /> <br />Santa Ana Work Center <br />Laura <br />1000 E. Santa Ana Blvd <br />Suite 200 <br />Santa Ana, CA 92701 <br /> <br />ACORD 25 (2001/08) <br /> <br />