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Williams Institute
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Last modified
1/3/2012 1:51:05 PM
Creation date
8/25/2005 3:00:07 PM
Metadata
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Template:
Contracts
Company Name
Williams Institute
Contract #
A-2005-078-046
Agency
Community Development
Council Approval Date
4/4/2005
Expiration Date
6/30/2006
Insurance Exp Date
11/4/2005
Destruction Year
2011
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SE~,D2-2935 09:33 FROM-INTERWEST/CORE <br />916-679-2977 T-514 P.002/002 F-393 <br />.~CORQ, CERTIFICATE OF LIABILITY INSUFWNC:C "'''° " ' <br />RAR716-1 09 OS 05 <br />PpODUCfA <br />Human aer"ioes Diviaioa <br />InterrQest In6uraaee 9er"ices <br />255188 <br />A THISCERT7FICATEISISSUEDASAMATT OFIN ATIO <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />A~TER HE COVERAG AFFORDED BY 7~ POLICEIFS BELOW <br />o>< <br />P.O. <br />Saoxamento CA 95865 <br />Phone: 800-448-5306 I'ax:916-488-3492 <br />INSURERS AFFORDING COVERAGE <br />NAIL fI <br />INSVRGD <br />-~^ <br />~ <br />'/ <br />p M&>AERA Re~eollt~' Af/nLVne~ ~L11amD <br />~- <br />O, J <br />O~O' ^ <br />~ <br />OYl (/T' IIIRIRER B' <br />TYlC hT1111ama Inatstnte, IACi• <br />bdLi gO <br />L <br />aC 11141RER L: <br />y <br />~f ]Iaia <br />y <br />202 <br />t~et DnuREfta <br />ta Apa CI- 92711 µSlpi62 E <br />COVEFUI[SES <br />THE F'oLlgES of INSURNac6 warm BETIDVII IwvE BEEN 1!:sllED TO THE nrsu RED IUD ABVJE FOR THE POl1CY p6RgD DiDICATED. NoivFl I1R IANIAnw <br />ANY REOUREARNT, TERN OR CONJlipll OF ANY CONTRACT CR OTHER OOC U.IENT WRH RESPECT YO WHICH T}II9 CERTIFICATE MAY EE 139E®OR <br />ANY PERTAN, THE fI5URAIJCE AFPORD® BY THE POLICES DE'xW3ED HER EPI IS 811BJECT TO ALL THE YERMS, E)CCLDEIONS AND CONDRpN9 OF SUCH <br />POLICEa. AOGSS~ATE LRaT9 9HWdN MAY HAVE BEEN REDUCED 9Y PAID CL M43. <br />LTR ASTt TYPE OPINf1AtANG! PODCf NUYaDI DA IL1TE. laR'9 <br /> DExER.L. u~ewTY EACH OCCURRENCE s1,000,OD0 <br />A % R CAIARERC4ALG[~F.TiAlL1AaLRY 2004-16614 NPO 11/04/09 11/04/05 PBE/AA5E5 ~ a 1D0,000 <br /> CLAIIW IAAeE %~OCII1R MFA p(P (MP a~px~on) SSO DDD <br /> PERBORILL.M1ALN WJURY f 1 DDD DDD <br /> cENEi1AL AGGREGATE F2, D00,000 <br /> GETR AGGREGATE UMRADPLFS PQt pftOOUCTS.LdAProDAGC f 2,DDD,DDD <br /> POLICY .PIE'~cl' LaC <br /> au mlADBf.eLIAlITTY c0a9uEG9VGLELiMTT t1,DDD,DDD <br />A % Ar+r AllTD 2 0 0 4-1 6 614-HPO 11/09/D4 11/04/05 ~"~°1A1I <br /> <br /> ALL Ci"Nm MR09 BOGILY lUJRY <br />S <br /> EGHEOULf+)AtROS R'x PX1a'I <br /> % NPI6DAUTC6 ~ <br />f <br /> % NGN-0NAIEDAIfI'OC <br /> E COIF Pao 500 P0.GPERTV DAAATAOE <br />3 <br /> % COLL. DII7 $500 E1'1Ci11'A <br /> oARADE WlMY AUTO QA.Y-EA AOOCE?!f S <br /> AAYAUTO OTrvEA1HAN ~~ _ <br />- - <br /> ALTO ONLY: A00 f <br /> ExceasaalBRa.uLUaiLm EACHOxuRREN~ s <br /> OCOJR ~ G1NEI5 \lAOL+ AGGREGATE 6 <br /> 4 <br /> P¢UOTBLE f <br /> REfENt10N i f <br /> YdDRI0H;5 COAIPENPATICN AHD TOM LAVTS ER <br /> lRPLOYERf' LIABILRY <br />ANY PRORRIETOR'4ARTNEWE%ECUTNE <br />F_L EACH ACCIDENT <br />S <br /> GPPIGERIMEMRER EIICL!~GmT EL. pP£A8E-EAE 3 <br /> u yyewe~~ ~.a.r, <br />9PE'.]I.L PROVGfIDN9 eJvw <br />EL Di9EASE•POL,LYLfMIf <br />9 <br /> OTH9{ <br />n PROF. $TILEILI2Y 200{-16614-NPO 11/04/04 11/04/05 ILE~a%OI1TE Si, 000,000 <br /> PER OCCUR SS 000 000 <br />DE]CRIPTION OP OPFliA'IION6 iLOCATpH6/YQIFLES! EiICID&Wb AWEDaY ENLUB6EIEMi! 1~ML PAONSi0N5 <br />city vs Santa Aaa, Its Ottierrrs, agents, EmDle,Tees aad volunteexa are aamad <br />addl.tioaal iAaured as ~undiAg source, Porn GG2026 attar3ed. <br />t8xoept 10 days aotiae of canaellatioa it non-payaleat of gcsnimL. <br />CERTIFICATE HOLDER CANCELLATION <br />a~,~ITA SNGLtDAHY OF THE AeGVE OESCRIB®PGLICIEa BECR11L8LE-BEPORETHE EkPIRATP <br /> DATE THEREOF, THE 166UNOIH6URER VALE AIL 3O* aLY3 WRfRFl! <br />City of Santa Aaa CD~BD 8-25 PIDTIGl TO THe CERTIPICATe Hatn®e NArmoTG TNEIgT, BUTRIL <br />c~manity Dowlogmat Aganay 7(D~01~17~MiDPx ~~ <br />P. O. Bex 1988 M-25 <br />Santa ]Iaa CA 92702 <br /> D NTA R <br />ACOR025(2001109J'F'R+.YLiJ ,3y `~~ ~'OItM <br />c <br />-- ~~-1/ / <br />~ <br />~ <br />'. aaru :i Cat Shced <br />- .,,,tent E~ity Attorney <br />®ACORD CORF'0 TI 1998 <br />
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