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ACbRDM CERTIFICATE OF LIABILITY INSURM E 06/29/204n <br />PRODUCER (949) 852-0909 V FAX (949) 852-1131 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Milestone Insurance Brokers ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />P.O. Box 19598 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />8 Corporate Park, Ste 130 <br />Irvine, CA 92623-9598 INSURERS AFFORDING COVERAGE NAIC # <br />INSURED Saint Joseph Ballet Company INSURERATravelers Indemnity Co. of CT <br />1810 North Main Street INSURER B. <br />Santa Ana, CA 92706 INSURER C. <br />INSURER D'. <br />INSURER E'. <br />(YIVFRAGFC <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDM <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 <br />NDD` <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />GENERAL LIABILITY <br />660529X380104 <br />06/24/2004 <br />06/24/2005 <br />EACH OCCURRENCE <br />S 1,000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />DAMAGE TO RENTED <br />S 100,000 <br />CLAIMS MADE O OCCUR <br />MED EXP (Any one person) <br />S 5,000 <br />A <br />PERSONAL SADVIWURY <br />$ 1,000,00 <br />GENERAL AGGREGATE <br />$ 2,000,00 <br />GEN'L AGGREGATE LIMIT APPLIES PER', <br />PRODUCTS - COMP/OP AGG <br />S 2,000,00 <br />17 POLICY 7 PRO- <br />JECT OC <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />S <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(Per person) <br />$ <br />HIRED AUTOS <br />NON-OWNEDAUTOS <br />BODILY INJURY <br />(Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />ANY AUTO <br />OTHEEA ACC <br />THAN <br />$ <br />8 <br />AUTO <br />AUTO ONLY pGG <br />EXCESSIUMBRELLA LIABILITY <br />OCCUR ❑ CLAIMS MADE <br />CUP346H8104 <br />06/24/2D04 <br />06/24/2005 <br />EACH OCCURRENCE <br />$ 1,000,00 <br />AGGREGATE <br />$ 1,000,000 <br />A <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />$ <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABILITV>y <br />ANY PROPRIETORIPARTNEWEXECUTIVE <br />OFFICER/MEMBER EXCLUDED' <br />nder <br />H yes, AL PR a PROVISIONS <br />SPECIAL PROVISIONS Below <br />\ / <br />\(<�_ <br />j <br />- <br />"'_c t_t <br />—j <br />/ <br />� <br />WC STATU- OTH- <br />IY I WITS FIR <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYE <br />$ <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />he City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, <br />gents and representatives are named as Additional Insureds/ Primary as respects General Liability <br />or the "City of Santa Ana's Community Development Block Grant." <br />*Ten (10) day notice Of cancellation for non payment of premium. <br />(:FRTIFI(.ATF Hill DIED <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />City of Santa Ana <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL*1XXX)Ok)w MAIL <br />Community Development Agency <br />_`°W DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />M-25 <br />K6)0IFXXhAW10WA%YJIAC)ldCt WyAXX'QW&YjX)6)12(&*YjWj0LYAU*XXX <br />P.O. Box 1988 <br />dfsKXW4(dANOk)iKX7fXK"N)txxx ' k)fiKlE6i#Y40fJfD(d6wXXXXXXXX <br />Santa Ana, CA 92702-1988 <br />AUTHORIZED REPRESENTATIVE `�1 ,Arex�12 <br />Roxan Hon ROX <br />ACORD 25 (2001108) ©ACORD CORPORATION 1988 <br />