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<br />AdJRDN CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIODNY) <br />7-16-2004 <br />Pi/OUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Carl L. Dieda Ins. Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 680 Langsdorf Dr. II 210 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Fullerton, Ca. 92831 , <br /> i INSURERS AFFORDING COVERAGE <br /> ¡ INSURER A. Gu1deUne ins. ~ompany ~----_._- <br />INSURED <br /> Templo Calvario and Church of No Walls INSURER B- <br /> 2617 W 5th sr. INSURER c: <br /> Santa Ana, ca. 92703 -- -.- <br /> INSURER D' <br /> , INSURER E- <br /> <br />COVERAGES <br /> <br />THE POLtCIES 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 /> <br />INSA i TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION <br /> <br />~ERAL LIABILITY I <br /> <br />A r -x¡ COMMERCIAL GENERAL LIABILITY - I <br /> <br />F=fJ CLAIMS MADE ~ OCCUR 1135 991 '6-1-2002 <br /> <br />~ 6-1-2003 <br /> <br />~ 6-1-2004 <br /> <br />FIRE DAMAGE (Anyone fire) <br /> <br />$ <br /> <br /> <br />EACH OCCURRENCE <br /> <br />LIMITS <br />$ <br /> <br /> <br />6-1-2003 <br />6-1-2004 <br />6-1-2005 <br />i <br /> <br />MED EXP (Anyone person) $ <br />PERSONAL & ADV INJURY $ <br />i GENERAL AGGREGATE $ <br />PRODUCTS. COMP/OP AGG $ <br /> <br />SCHEDULED AUTOS <br />HIRED AUTOS <br /> <br />Øu# <br /> <br /> <br />I <br />! <br />I <br />i <br />//4 <br />! <br /> <br />, <br />,,' COMBINED SINGLE lIMI----L-T I $ <br />: (Eaaccident) <br />r-- . <br />I BODilY INJURY i $ <br />i (Per person) ! <br />I <br />$ <br /> <br />BODilY INJURY <br />(Per accident) <br /> <br />ANY AUTO <br />All OWNED AUTOS <br /> <br />NON.OWNED AUTOS <br /> <br />PROPERTY DAMAGE <br />(Per accident) <br /> <br />$ <br /> <br />GARAGE LIABILITY <br />ANY AUTO <br /> <br />DEDUCTIBLE <br />RETENTiON <br /> <br />$ <br /> <br />AUTO ONLY. EA ACCIDENT $ <br />EA ACC $ <br />AGG $ <br />$ <br />$ <br />$ <br />$ <br />$ <br /> <br />OTHER THAN <br />AUTO ONLY: <br /> <br />EXCESS LIABILITY <br />OCCUR D CLAIMS MADE <br /> <br />EACH OCCURRENCE <br />AGGREGATE <br /> <br />OTHER <br />i <br />i <br />i <br />DESCRIPTION OF OPERATIONSlLOCATlONSNEHIClESJEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br /> <br /> <br />I I WC STATU- OTH. <br />!-~~-~~:;Z~~~~~~~$--l . 000 ~ÕOO <br />~SE~SE. EA EMPlOYE~ 1.000 000 <br />, E.l. DISEASE. POLICY LIMIT I $ 1 000 000 <br /> <br />I WORKERS COMPEr.¡SATlON A!'!':! <br />EMPLOYERS' LIABILITY <br />A <br /> <br />1216 380 <br /> <br />I ' <br />! ' <br />i 10-1-2003 110-1-2004 <br /> <br />c ~v~t1.es 0 <br /> <br /> <br />For partnership between Templo Calvario and City of Santa Ana in finding <br />in the surrounding communities. Thru resource center at the church. <br />Beginning 7-1-2004 <br /> <br />jobs for families <br /> <br />CERTIFICATE HOLDER <br /> <br />i ADDITIONAL INSURED; INSURER LETTER: <br /> <br />CANCELLATION <br /> <br />The City of Santa Ana, its Officers, Agents <br />and Employees. Santa Ana Work Center <br />1000 E. Santa Ana Blvd. Suite 200 <br />Santa Ana, Ca. 92701 <br />Attn: Bea Gonzalez <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL EHiIIUIQ(IIIKK) MAil ~ DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE1œÐt](~maxJS QJGK1ICIC <br />IJII!I:ImtXtX~~JtJaJaX1JP.l J[:mEXŒII8EJI~JRI[ <br />"""""'" <br /> <br />ACORD 2S-S (7/97) <br /> <br /> <br />@ ACORD CORPORATION 1988 <br />