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LIABILITY INSURANCI <br />DATE (MMIDDIYYYY) <br />&oKD CERTIFICATE <br />3vanced Insurance Marketing <br />.O. Box 4459 <br />range CA 92863-4459 <br />hone: 714-997-8100 <br />Human pOpptions <br />Attn: bfary Alderson <br />P.O: BOx 53745 <br />Irvine CA 92619-3745 <br />THIS CERTIFICATE IS ISSUED AS A MATTER Ur INrumm. 11, ,. <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 NAIC # <br />INSURER A: milaAelpNia Indemnity inn Co <br />INSURER C: <br />INSURER D: <br />V V enenv�o <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PoLIC ES AGGREGATE L AIN, THE ANC AFFORDED MAY BY THE HAVE BEEN REDUCED DES RIBED HEREBY PAID IN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />ITP <br />L BATE MMIDD <br />,LSR TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDIYY) <br />I EACH OCCURRt <br />1 A I X <br />A <br />A <br />GENERAL LIABILRY <br />X COMMERCIAtGENERALLIABILITY PHPK060405 <br />CLAIMSMADE KOCCUR <br />GE IML AGGREGATE LIMIT APPLIES PER <br />IL POLICY n JE& F LOC <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />X HIRED AUTOS <br />X NON-0WNED AUTOS <br />GARAGE LIABILITY <br />ANY AUTO <br />PHPK060405 <br />09/23/031 09/23/04 <br />LIMITS <br />$1,000,00 <br />$100,000 <br />MED EXP (MY one person) E 5 , OOO <br />PERSONAL A ADV INJURY E1,000,000 <br />GENERAL AGGREGATE E1,000, 000 <br />PRODUCTS-COMP/OP AGO I EI, OOO,OOO <br />o.,,.. nen I 1,000,000 <br />COMBINED SINGLE LIMIT I S 1000000 <br />09/23/03 09/23/04 (Ea acrid M) <br />EXCESSAIMBRELLA LIABILITY IKD 09/23/03 <br />OCCUR CLAIMSMADE PHuB022837 <br />APPROVED AS TO P <br />HDEDUCTIBLE <br />X RETENTION E10,00( <br />WORKERS COMPENSATION AND <br />EMPLOYERS LIABILITY <br />FFICERIMEMBEREXCLUD EXCLUDED? <br />O <br />A I Property - RC <br />Vaura Stieedy <br />Deputy City , <br />BODILY INJURY E <br />(Per person) <br />BODILY INJURY E <br />(Per ac dent) <br />(Per accidmIPROPERTY �AMAGE E <br />AUTO ONLY -EA ACCIDENT E <br />OTHERTHAN EA ACC E <br />AUTO ONLY: AGG E <br />EACH OCCURRENCE E 4000000 <br />09/23/04 AGGREGATE E 4000000 <br />M E _ <br />E <br />E <br />E.L. EACH ACCIDENT E <br />E.L. DISEASE - EA EMPLOYE E_ <br />E.L. DISEASE - POLICY LT <br />E <br />09/23/03I 09/23/04I Contents $340,000 <br />PHPK060405 eT nnn <br />DESCRIPTION OF OPERATIC" I LwnI I —I •�•••�---• - --------- <br />10 day notice of cancellation for non-payment Of premium. Certificate <br />Holder, its officers, employees, agents, volunteers and representatives and <br />Minnie Street Family Resource Center are named Primary Additional Insured <br />per form attached. Sexual Misconduct Limit $1,000,000. <br />E HOLDER <br />CITYOF3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATII <br />DATE THEREOF, THE ISSUING INSURER WILL gallIPM MAIL 30 DAYS WRITTEN <br />The City Of Santa Ana NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />Comm. Development Agency M-25 <br />Attn: Carla Thompkins - <br />20 Civic Center Plaza AUTHD E ATIVE <br />Santa Ana CA 92702 <br />ACORD 25 (200 106) A4pr <br />