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SOCIEPALI <br />�ORDrM CERTIFICATE OF LIABILITY <br />DATE (MMIDDM'YY) <br />INSURANCE 07/30/04 <br />PRODUCER <br />US] Northern California <br />50 California Street, 24th Floor <br />THIS CERTIFICATE IS 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 />San Francisco, CA 94111 <br />877 490-7535 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />Society of St Vincent de Paul <br />INSURER A'. State Compensation Insurance Fund of <br />INSURERS: <br />INSURER C. <br />422 West Almond Avenue <br />INSURERD: <br />Orange, CA 92666 <br />INSURER E: <br />uuvt HOCO <br />THE POLICIES 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 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 />LTR <br />um <br />NSRC <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MIDDNYJ <br />POLICVEXPIRATION <br />DATE MM/DD/YV <br />LIMITS <br />GENERAL LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />S <br />DAMAGE TO RENTED <br />PREMISEn r <br />$ <br />MEO EXP AnY ono person) <br />$ <br />CLAIMS MADE OCCUR <br />PERSONAL&ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />$ <br />PRODUCTS - COMP/OP AGG <br />$ <br />GENT AGGREGATE LIMIT APPLIES PER: <br />POLICY M PRO LOG <br />JEGT <br />AUTOMOBILE <br />LIABILITY <br />n p <br />`yy pRv <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />Laura Stit <br />Sh„cdy <br />BODILY INJURY <br />(Per person) <br />$ <br />BODILY INJURY <br />(Per accident) <br />$ <br />HIRED AUTOS <br />ASSLSTOLL Cl <br />y <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHER THAN EA ACC <br />$ <br />ANY AUTO <br />$ <br />AUTO ONLY: AGG <br />EXCESSIUMBRELLA LIABILITY <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />OCCUR CLAIMS MADE <br />S <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />A <br />WORKERS COMPENSATION AND <br />166284604 <br />01/01/04 <br />01/01/05 <br />X WCSTAru- oTH- <br />) <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/ RIEXECLITIVE <br />OFFICER/MEMBER EXCLUDED? <br />E.L. DISEASE - EA EMPLOYEd <br />$1,000,006 <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS [VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />Cancellation: Except for ten day notice for non-payment of premium. <br />nUG04104 AM11 �05 <br />PUR <br />RE: Assistant to ex -offenders. <br />NIP <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />I ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />IEREOF, THE ISSUING INSURER WILLItE7Q(9(1QRX9t MAIL An DAYS WRITTEN <br />TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, AKRW91ROrX %%)MP1f )dX <br />AUTHORIZED <br />ACORD 25 (2001108) 1 of 2 #S63639/M59418 <br />© ACORD CORPORATION 1988 <br />