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ACOR,. CERTIFICATE' OF LIABILITY INSURANCE o7/14/2005 <br />PRODUCER (949)852-0909 FAX (94>)852-1131 THIS CERTIFICATE IS r_. UED AS A MATTER OF INFORMATION <br />Milestone Insurance Brokers ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P.O. Box 19598 <br />8 Corporate Park, Ste 130 <br />Irvine, CA 92623-9598 <br />INSURED -Saint Joseph Ballet Col <br />1810 North Main Street <br />Santa Ana, CA 92706 <br />INSURERS AFFORDING COVERAGE <br />INSURERA. Travelers <br />INSURER B. <br />INSURER C <br />INSURER D: <br />INSURER E. <br />Co. of CT <br />NAIC # <br />v THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINI <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 />F INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />ITEampmanctrinin <br />LIMITS <br />ITY <br />660529X380105 <br />06/24/2005 <br />06/24/2006 <br />EACH OCCURRENCE <br />$ 1„000,00 <br />DAMAGE TO RENTED <br />$ 100 00S <br />IAL GENERAL LIABILITY <br />MADE OCCUR <br />MED E%P(Any one person) <br />$ 5,000 <br />PERSONALBADVINJURY <br />$ 1,000,0QGENERALAGGREGATE <br />Ty: <br />$ 2,000,00TE <br />LIMIT APPLIES PER'. <br />PRODUCTS-COMPIOPAGG <br />$ 2,000,0DPRO <br />ECT LOC <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />BODILY INJURY <br />(Per person) <br />$ <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(Par accident) <br />$ <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE <br />(Per accident) <br />S <br />GARAGE LIABILITY <br />AUTOONLY-EAACCIDENT <br />$ <br />OTHER THAN EA ACC <br />$ <br />ANYAUTO <br />$ <br />AUTO ONLY. AGO <br />EXCESSIUMBRELLALIABILITY <br />CUP3461-18105 <br />06/24/2005 <br />06/24/2006 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />X OCCUR El CLAIMS MADE <br />AGGREGATE <br />$ 1,000,000 <br />$ <br />A <br />$ <br />DEDUCTIBLE <br />$ <br />X RETENTION $ 10,00 <br />WORKERS COMPENSATION AND <br />' ` - <br />FORM <br />- <br />I ORWC STATU- OTHFIR <br />EMPLOYERS' LIABILITY <br />ANY PEIFUME TORT EXCLUDED' <br />OFFICERIMEMBEft E%CLUDEU? <br />L� <br />EL EACH ACCIDENT <br />$ <br />E.L. DISEASE EA EMPLOYEE <br />$ <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />-_A <br />E. L. DISEASEPOLICYLIMIT <br />$ <br />OTHER <br />,IllflUtz ILy At <br />OTRC}r <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />The 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 />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ICX1X1k>EM MAIL <br />City of Santa Ana <br />*30 <br />Community Development Agency <br />DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />M-2 S <br />BXNX��A(db�XallYJ()(dfDfd(:14XIXXd(AGEI(l(d(16➢4NrY�Ji?N4M1iXD0(IYJ(i(XX <br />P.O. Box 1988 <br />BKMVA*DN(AEd@(MIEXd@GIO )tXXd(AXX)iKXN#XXXXXVMXXXXXXXX <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92702-1988 <br />Sheri Flourno /SDF <br />ACORD 25 (2001108) ©ACORD CORPORATION 1988 <br />