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• 0 a <br />ACO{ v„ CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DDMY1 <br />10118/2005 <br />- ODUCER Serial # 100398 <br />ANDERSON & MURISION INC <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 />800 WEST COLORADO BLVD <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />LOS ANGELES, CA 90041 �_���_���]_[� <br />INSURANCE LIC #0323106 A ;lCo5_00 <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURED <br />INSURER A: SCOTTSDALE INSURANCE COMPANY <br />INSURER B: <br />THOMAS HOUSE TEMPORARY SHELTER <br />PO BOX 2737 <br />INSURER C: <br />INSURER D: <br />GARDEN GROVE, CA 92842 <br />INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A80VE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACTOR OTHER DOCUMENTWITH RESPECTTO WHICHTHIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS, EXCLUSIONS ANDCONDITIONSOFSUCH <br />SC.EFFE <br />POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLApTE IML�yMWO <br />TYPE OF INSURANCE <br />POLICYNUMBER POA <br />PO N <br />LNARS <br />GENERAL DABILRY <br />EACHOCCURRENCE <br />$ 2000,000 <br />A <br />X COMMERCIAL GENERALLIABILIFY <br />CLS1099096 <br />07.09.05 <br />07.09.06 <br />RMEJOAE 'nee <br />$ 100,000 <br />CLAMS MADE FXJ OCCUR <br />WED EXP(Any we person) <br />$ 5,000 <br />PERSONAL &ADV INJURY <br />$ 2,000,000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GENL AGGREGATE LIMIT APPLIES PER <br />PRODUCTS - COMP /OP AGG <br />$ INCLUDED <br />X POLICY J E O ° LOC <br />SEXUAL ABUSE <br />25,000/50,000 <br />ALMOMOSILE <br />LIABILITY <br />ANY AUTO <br />COMBWED SINGLE LIMrt <br />(Ea eccitlenq <br />$ <br />GODLY INJURY <br />(Per person) <br />$ <br />ALL OPMED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(POT accident) <br />$ <br />HIRED AUTOS <br />NON -OWNED AU f05 <br />PROPERTY DAMAGE <br />(Peracad.rr) <br />$ <br />GAR m AGE LMSIL <br />AUTOONLY- EAACCIDEW <br />$ <br />OTHER THAN EA ACC <br />$ <br />ANY AUTO <br />$ <br />AUTOONLY AGG <br />EXCESSUMBRELLALIABILm <br />EACHOCCURRENCE <br />$ <br />OCCUR CLAIMS MADE <br />AGGREGATE <br />S <br />$ <br />DEDUCTIBLE <br />RETENTION $ <br />$ <br />WORKER'S COMPENSATXMNAND <br />EMPLOYERS' LIABLm <br />WC STATU. TH <br />TORY LIMITS ER <br />EL EACH ACCIDENT <br />$ <br />ANY PROPRIETORIPARTNERAXECUTIVE <br />EL DISEASE EA EMPLOYEE <br />4 <br />OFFICERdEMBER EXCLUDED> <br />1yas, tlescnDe antler <br />EL DISEASE - POLICY LIMIT <br />$ <br />SPECIAL PROVISIONSDeIaw <br />OTHER <br />DESCRIPTION OF OPERATIONSLOCATION SNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br />SHELTER <br />CERTIFICATE HOLDER IS INCLUDED AS AN ADDITIONAL INSURED AS THEIR INTEREST MAY APPEAR <br />CERTIFICATE HOLDER CANCELLATION <br />SHOLLD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION <br />CITY OF SANTA ANA - CDBGM -25 COMMUNITY <br />DEVELOPMENT AGENCY <br />DATE THEREOF, THE ISSUING INSURER WLL)0tVXf)0MMAL 30 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFTeUr <br />CITY OF SANTA ANA <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR <br />P.O. BOX 1988 <br />REPRESENTATIVES. <br />AURHORREDREPRESENTATNE OF INDEPENDENT INSURANCE AGENCY <br />SANTA ANA, CA 92702 <br />ACORD 25 (2001/08) <br />C VMPROtCERTPROS.FP5 <br />AP <br />j y -- <br />A. "'Istant City Att�?Tn <br />® ACORD CORPORATION 1988 <br />