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ACORD�, CERTIFICATE OF LIABILITY INSURANCEPage 1 of 2 <br />07/07/2004 <br />PpDDUCEP 877- 945 -7378 <br />Willis North America, Inc. - Regional cart Center <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 />26 Century Blvd. <br />POLICY EXPIRATION <br />A D <br />6/30/2005 <br />P. O. Box 305191 <br />Nashville, TN 372305191 <br />INSURERS AFFORDING COVERAGE <br />INSURED Sisters of St. Joseph of Orange <br />INSURER A. American Unity Group Ltd C0929 -001 <br />Santa Ana Work Center <br />480 South Batavia <br />INSURER B. <br />INSURER C: <br />Orange, CA 92B68 <br />INSURER D' <br />$ <br />INSURER E. <br />COVERAGES <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 />INSR <br />TR <br />A <br />TYPEOFINSURANCE <br />GENERAL LIABILITY <br />POLICY NUMBER <br />DNI- CGL -04- 01-020 <br />POLICYEFFECTIVE <br />6/30/2004 <br />POLICY EXPIRATION <br />A D <br />6/30/2005 <br />LIMITS <br />EACHOCCURRENCE <br />$ 2,000,000 <br />aaWba- ` xa�wxer uA> f�, xX) xxlxmnc�ax�rlmclxcrliOxizt >rr�tlw�ssaixxx�sa�rx <br />Santa Ana Work Center <br />X COMMERCIAL GENERAL LIABILITY <br />1000 E. Santa Ana Blvd. <br />gUTi{D IZEO <br />Suite 20D0 <br />FIRE DAMAGE (Any one fire) <br />$ <br />CLAIMSMADE 1 OCCUR <br />MED EXP(Any one person) <br />$ <br />PERSONAL &ADV INJURY <br />$ 2,000,000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />PRODUCTS - COMP /OP AGG <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO LOC <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />(Ea accitlenq <br />$ <br />BODILY INJURY <br />(Per person) <br />$ <br />LHIRE(DAUTOS <br />BODILY INJURY <br />$ <br />- <br />PROPERTYDAMAGE <br />(Peraccitlent) <br />$ <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />S <br />OTHERTHAN EA ACC <br />AUTO ONLY: AGG <br />$ <br />ANY AUTO <br />S <br />EXCESS LIABILITY <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />OCCUR CLAIMS MADE <br />- -_,r S 0VV'D <br />'`O't... <br />�S <br />$ <br />DEDUCTIBLE <br />RETENTION $ <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABILITY <br />� <br />)- '� <br />p\ <br />'K <br />{1OPI }" <br />H- <br />TN RY STATIU LIMT OTR <br />$ <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE -EA EMPLOYEE <br />$ <br />E.L.DISEASE- POLICYLIMF <br />$ <br />l <br />OTHER <br />DESCRIPTION OF OPERATIONWLOCATIONSNEHICLESIE XCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br />The Certificate Holder is named as Additional Insrued by endorsement to the policy subject to the <br />terms set forth in the endorsement. <br />Re: SSJO dba Taller San Jose, Block Grant - 810 N. Poinsetta, Santa Ana, CA 92701 <br />H <br />OLDER INSURED' INSURER LETTER: CANCELLATION <br />CERTIFICATE ADDITIONAL <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL 2 WOh°76RXXX MAIL 30 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEF 'i>;6Q]['J.'7GNffiKXIXDt4C9WG7PYLL <br />aaWba- ` xa�wxer uA> f�, xX) xxlxmnc�ax�rlmclxcrliOxizt >rr�tlw�ssaixxx�sa�rx <br />Santa Ana Work Center <br />i5�7C4G1f65X %X <br />1000 E. Santa Ana Blvd. <br />gUTi{D IZEO <br />Suite 20D0 <br />Santa Ana, CA 92701 <br />�ESENTATVE <br />1 <br />ACORD 25- S(7197) Coll:1036362 Tp1:280941 Cert ?4564914 ©ACORDCORPORAM. 1988 <br />