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<br />- <br />. ACJ2BD,. CERTIFICA7--~ f LIABILITY INSU~r- I O¿~ï;~/~;V; <br />PRODUCER (626) 599-8830 FAX {ò26) 599-8831 THIS CERTIFICATE 1" 'ISSu"t¡ AS A MATTER OF INFORMATION <br />Pacific General Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />405 E. Santa Cl ara Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Suite 100 <br />Arcadia, CA 91006 INSURERS AFFORDING COVERAGE NAIC # <br />INSURED Mexican American Opportunity Foundation INSURER A; Philadelphia Insurance Company <br /> 401 N. Garfield Avenue INSURER B: <br /> Montebello, CA 90640 INSURER c: <br /> INSURER D: <br /> INSURER E: <br /> <br />COVERAGES <br />THE POLICIES OF iNSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY -PERIOD INDiCATED. NOTWITHSTANDINI <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 /> <br />INSR DO' <br /> <br />TYPE OF INSURANCE <br />GENERAL LIABILLTY <br /> <br />POLICY NUMBER <br /> <br />POLICY EFFECTIVE <br /> <br />POLICY EXPIRATION <br /> <br />LIMITS <br /> <br />PHPK071751 01/30/2004 <br /> <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE [8] OCCUR <br /> <br />MED EX? (Anyone person) <br />PERSONAL & ¡...oV INJURY <br /> <br />s <br /> <br />1,000,000: <br />100,000 <br />5,000, <br />1,000,000 <br />3,000,000 <br />3,000,000 <br /> <br />01/30/2005 <br /> <br />EACH OCCURRENCE <br />DAMAGE TO RENTED <br /> <br />$ <br />S <br /> <br />A <br /> <br />X <br /> <br /> <br />GENERAL AGGREGATE $ <br />PRODUCTS. COMPtO? AGG $ <br /> <br />lOC <br /> <br />AUTOMOBILE LIABILITY <br />X ANY AUTO <br /> <br />PHPK071751 01/30/2004 <br /> <br />01/30/2005 <br /> <br />COMBINED SINGLE LIMIT <br />(Eaaccident) <br /> <br />s <br /> <br />1,000,000 <br /> <br />A <br /> <br />x <br /> <br />ALL OWNED AUTOS <br />SCHEDULED A;)TOS <br /> <br />BOOtl Y INJURY <br />(Per person) <br /> <br />s <br /> <br />HIRED AUTOS <br />NON-OWNED AUTOS <br /> <br />BOQIl Y INJURY <br />(per accident) <br /> <br />s <br /> <br />PROPERTY DAMAGE <br />(Per accident) <br /> <br />s <br /> <br />GARAGE LIABILITY <br />ANY AUTO <br /> <br />AUTO ONLY - EA ACCIDENT <br /> <br />s <br /> <br />OTHER THAN <br />AUTO ONLY: <br /> <br />EA ACC S <br />AGG $ <br />S <br /> <br />EXCESS/UMBRELLA LIABILITY <br />OCCUR D CLAIMS MADE <br /> <br />EACH OCCURRENCE <br />AGGREGATE <br /> <br />s <br />s <br /> <br />DEDUCTIBLE <br />RETENTION <br /> <br />s <br /> <br /> <br /> <br />s <br />s <br /> <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNERfEXECUTIVE <br />OFFICERfJl..IEMBER EXCLUDED? <br />lIyes,describeunder <br />SPECIAL PROVISIONS below <br />OTHER <br />rime Coverage <br />A Professional Liability <br /> <br />OTH- <br /> <br />E.l. EACH ACCIDENT <br /> <br />s <br /> <br />PHPK071751 <br />PHPK071751 <br /> <br />01/30/2004 <br />01/30/2004 <br /> <br />01/30/2005 <br />01/30/2005 <br /> <br />E.t. DISEASE. EA EMPLOYE S <br />E.l. DISEASE - POLICY LIMIT S <br />Limit $1,000,000/$2,000 Ded <br />$1,000,000 OCC/$3,OOO,OOO OCC <br /> <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENOORSEMËNT I SPECIAL PROVISIONS <br />he City of Santa Ana, its officers, employees, agents, volunteers and <br /> <br />dditional insured as respects to claims arising out of the operations <br /> <br />ehalf of the named insured. <br /> <br />representatives are named as <br />and uses performed by or on <br /> <br />ten day Notice of Cancellation shall be given in the event of non-payment of premium. <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />City of Santa Ana <br />Community Development Agency <br />Attn: Carla Thompkins- Mngt, <br />P.O. Box 1988 <br />Santa Ana, CA 92702-1988 <br /> <br />(M-25) <br />Aide <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ~~ MAIL <br />~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. <br />~òíJOOt_Jr:¡¡~Xi.~X)(O:¡'¡~~x*XJ¡¡J(iúXJ(XX <br />1!(¡(/óX')f;)OO(j;¡M¡(~m¡:)tXX1OO(X¡'¡K)(èIJóX~XXXXXXXX <br /> <br />AUTHORIZED REPRESENT TN <br /> <br /> <br />@ACORD CORPORATION 1988 <br />¡11.ee, <br /> <br />Michael Martin <br /> <br />ACORD 25 (2001/08) <br />