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<br />ACORD <br />ru <br /> <br />I DATE (MMlDDNYYYI <br /> <br />01/31/2006 <br /> <br />THIS CERTIFICATE I:; ISSUED AS A MATTER OF INFORMATION <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 /> <br />CERTIFICATE OF LIABILITY INSURANCE <br /> <br /> THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING <br />ANY REQUIREMENT. TERM OR CONDITiON OF ANY CONTRACT OR OTHER DOCl,.JMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AU TIiE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />I TYPE OF INSURANCE POLlCY NUMBER DATE M~~ UMITS <br />LTR NSR DATE MM'DD <br /> GENERAL LIABILITY PHPK156499 Olj30/2006 01/30/2007 EACH OCCURRENCE , 1,000,000 <br /> ~ <br /> X COMMERCiAl GENERAL UABILlTY PREMISES 'tE:'~~~n 'pl , 100 000 <br /> I CLAIMS MADE [!] OCCUR MED EX? (Anyone person) , 5,000 <br />A X PERSONAl & ADV INJURY , 1,000,00 <br />e- <br /> GENERAL AGGREGATE , 3,000,00 <br /> e- <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-CaM~OPAGG $ 3,000,00 <br /> !xl 'n:RO' n <br /> X POLICY JECT lOG <br /> AUTOMOBILE LIABILITY PHPK156499 01/30/2006 01/30/2007 COMBINED SINGLE LIMIT <br /> X ANY AUTO (Ea accident) . 1,000,OOU <br /> -:..:. <br /> ALL OWNED AUTOS BODILY INJURY <br /> - $ <br /> SCHEDULED AUTOS (Per person) <br />A X - HIRED AUTOS <br /> - BODILY INJURY <br /> NON.QWNED AUTOS (Per accident) , <br /> - <br /> . . PROPERTY DAMAGE $ <br /> ~ fO~ . (Peraccidenl) <br /> GARAGE L1ABII..ITY tS'2f.,.O"f,~ }\~ ~/'"' AUTO ONL Y ~ EA ACCIDENT $ <br /> ==j ANY AUTO ~. OTHER -mAN ""Ace , <br /> AUTO ONt V: AGG $ <br /> EXCESS/UMBRELLA LIABILITY , t. 5 I>-\\O(\W~ EACH OCCURRENCe s <br /> b OCCUR 0 CLAIMS MADE \-151>- 'Ci\' AGGREGATE , <br /> f'SSlston\ ([ o-f 1--) s <br /> R DEDUCTIBLE $ <br /> RETENTKlN $ S <br /> WORKERS COMPENSATION AND I TORY LIMITS I IV." <br /> ENlPLOYERS'llABIUTY <br /> ANY PROPRIETORIPARTNERlEXECU1lVE .e.L. EACH ACCIDENT S <br /> OFFrCERlMEMBER EXCLUDED? e.L. DISEASE - EA EMPLOYEE S <br /> .ryes, describe undllr <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ <br /> OTHER PHPKlS6499 01/30/2006 Olj30/2007 See Below <br /> rime Coverage <br />A Professi ona 1 Li abi 1 it:y PHPKI56499 01/30/2006 01/30/2007 $1,000,000 OCC/$3,OOO,OOO OCC <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES' EXCLUSJONS ADDEO BY ENDORSEMENT / SPECIAL PROVISIONS <br />ity of Santa Ana, its officers, agents and employees are named as additional insureds with <br />~espects to all operations by the named insured for general liability only as a funding Source. <br />~ ten day notice of cancellation shall be given in the event of non-payment of premium <br /> <br />PRODUCER (626) 599-8830 FAX (626) 599-8831 <br />Pacific General Insurance Services <br />405 E. Santa Clara Street <br />Suite 100 <br />Arcadia, CA 91006 <br />INSURED Mexican American Opportun; ty Foundation <br />401 N. Garfield Avenue It - :rOU'(^J 4) f ? DY <br />Montebello, CA 90640 <br />/?-- '.? & U 't- /7J/ A - .... u "'I <br />/I-,7u of'-; J." A --' '" OJ -- <br />, <br /> <br />_ ';0'/ <br />07 y' V..;J'f" <br /> <br />COVERAGES <br /> <br />CERTIFICATE HOLDER <br /> <br />City of Santa Ana/Fez Daisy Wheel Network <br />Santa Ana Work Center <br />Attn: Bea Gonzalez <br />1000 E. Santa Ana, Suite 200 <br />Santa Ana, CA 92701 <br /> <br />ACORD 25 (2001/08) FAX: (714) 565-2602 <br /> <br />INSURERS AFFORDING COVERAGE <br /> <br />INSURERk Philadelphia Indemnity <br />INSURER B: <br />INSURER c: <br />INSURER 0: <br />INSURER E: <br /> <br />NAIC# <br /> <br />Insurance Company <br /> <br />CANCELLATION <br />SHOULD ANY OF TIlE ABove DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ~ MAIL <br />-.3.!L.. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAJ/lEO TO THE lEFT, <br /> <br />