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<br />89/26/2885 8d:36
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<br />5652682
<br />
<br />WORK CENTER
<br />
<br />PAGE 02
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<br />ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlOorrVYY,
<br /> TM 0712712005
<br />liJitOOUC"R Schwei~kert & Company THIS CERTIFICATE IS ISSUED All A MATTER OF INFORMATlOII
<br /> ONLY AND CONFEllS 110 RIGHTS UPON THE CERTIFICATE
<br /> ] 5 Peters Canyon Road HOLDE!!. THIS CERTIFIC:ATE DOES NOT AMeND, eXTEND OR
<br /> Jr\..;ne CA 92606 ALTER THE COVERA9E AFFORDeD BY THE POLICIES BELOW.
<br /> INSURERS AFFORDING COVERAGE NAICII
<br /> .--.--.- -. .'NSURERA NonProiitinslU'IIllce Alliance ofCA -.-'. -
<br />IN...,,,,,,, Templo Calv.rio Community .Development Corporation
<br /> 1-''''--_. -.. .... .....--
<br /> 2511 Woo 5tb Street 'NSl!!!~B_B:. ._--. " -
<br /> Santa Ana CA 92703 Jt!~U_"EA,_C' -. _. . .n.._ .n_
<br /> INSUAGR. C, ----" .--.--
<br /> IN'~R<R <, Slirte Compens.tlon Ins. Fund
<br />
<br />COVERAGES
<br />
<br />THE POLICIES OF INSUIlANCE ~ISTED BELOw HAVE BEEN IMUOD TO THE INSURED NAMOD ABOVO FOR THE POLICy PERIOD INDICAT_D. NOTWITHSTANDINl>
<br />ANY ROOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHOR DDCUMONT WITH RESPECT TO WHICH THIS CERTIFICATE MAY B_ ISSU_D OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE ~OLICIOB DOBCRIBoD HoRolN IS 5UBJOCT TO ,,~~ THE TORMS. EXCLUSIONS AND CONDITIONS OF SUCH
<br />1~~E.!l'GGREQ:"T. LIMITS SHOWN MA.Y HAVE BE!,~ REO!JCED BY ~AID 9.l!."MS. .__ ._ _
<br />=~ I POUCYNUMBER; P'Cl..ICl'!PJ~TN~ POI.IOl"DPlRATION liMIts
<br />
<br />X _Cc.N....ll,lMi~'rv 2005.]7088 0211112005 02/1112006 EACHOCOURRENCE .
<br />A. X ~ DAMAGI! TO RI!NTEO"'" "
<br />-" ,.COP.A....I!MIAl. c.. ENEJIW. _..L1ASIJ,1i'Y' Pro fu!:Jlinnlll."d Abll~ !lub!imil~ .PREML$~~~rxIIl J._
<br />- "I CLAlMSMAOE lli:J OCCUR ~ $l,OOO~OOO per OUi.lffencc~ ME:O ~ rAnvo~-':!.l!I!lJlonl ,.~_
<br />X Social SelVic.: Prof, $1.000,000 "AAJllsllto '='JlNA'O !\D\IINJURY ,
<br />x Abuse..!-iabi!ity"- ..' GENERA!. AOO.E<lATE . _..
<br />_G_~.~.l il\,GGR~E. LIMIT ATPPUI!!~ PI;:R. PRODUCTS ~ COMPICP ~_ $ _._.
<br />Xlprlllcvl I~~o. ~IOC
<br />
<br />]000000
<br />100000
<br />... -- U_ f 0000
<br />1000000
<br />2000000
<br />. rOOOOOO
<br />
<br />A
<br />
<br />x
<br />
<br />~\JTOI'lIIDI!!IILE LIAttIUTY
<br />I AtfY ~UTO
<br />_. AI.I. OWNED/WTOS
<br />SCHEOUlEO AUTO&
<br />~ ~I"E.D AUTOS
<br />~ NON-.OWN!;;'O AUTOS
<br />
<br />'- ..
<br />
<br />2005-1 7088
<br />
<br />0211112005 021] 112006 COMBINED SINGLE lIMIT . 1000000
<br /> [E"8I1CGfd8nlt
<br /> .-+ --
<br /> I
<br />, eODllY1NJU~ I'
<br /> I~"""onl
<br /> --.'" un ---. n. __.
<br /> "OOll V INJURY , $
<br /> {PMh~dM!)
<br /> r-A.Of'f:ffTY ONMGE .
<br /> (Pep aeel6MI)
<br />
<br />~AOE UABIUTY
<br />-r ANY AUTO
<br />
<br />AUTO ONI. y. EA ACOIDENT S
<br />A PROVED 1\S TO P01N..~THAN _I;M<;,_' .___ .....
<br />AUTO ONLY: AGG Sl
<br />
<br />~A n,if, , J t2..... EACH OCC~A~~. .
<br />f 1'::(uro. Snt Sflocdy ~<;ATE_ :
<br />A.ssistlUlt C ty'ALlorney -... ..
<br />
<br />~C3SIUMBREUA LIAJIrUTY
<br />---3 OCCUR D OlAIMS W<OE
<br />
<br />=1 ~:oucrIDlE
<br />E1F.NTlON S
<br />E WORKI;R8COMPliNSlttlDNANC' 1816178.
<br />91IPLDYI!RlI'lJA81UTT
<br />ANY ~IilOP~lrITO~IJ.lARTN~RlEXECU'l"lV!
<br />Of!F',eertIMEMBER E)((ll,UgE.lJ?
<br />I Ul:~r~crlbtl ~l'Ir
<br />OTH!!R
<br />
<br />0111212005
<br />
<br />0110] 12006
<br />
<br />__ I.
<br />I
<br />X I _WC STAT~ I IO}H-
<br />-l..lDRY 1.IMIIS...l.-....I....EfL ___
<br />e.J","f!I\C~OIC,it'lL-. .$_
<br />; E.L DISI!ASIii _ EA. EMPlOy!!!!1 tr.
<br />~~;O;S;:lI.il:~'_ftOlICYUMIT I tr.
<br />
<br />1,000,000
<br />1,000,UUO
<br />'1,000,000
<br />
<br />DE8ClVTION OF OPF!;M.TIONS r LDCA,T1ONs' WMICLQ., ExCLUSIONS ADOI!O IV ENOOR&I!!!MI!lIllT; IPEtWlAL PftOYI&lCINU
<br />11,. City of Santa Ana, ils offici. Is, employee., and represent.tives are hereby named as additional iMuted. as respects Templo
<br />Calvaria Commllnity DevelO)lment COrporation.
<br />
<br />CERTIFICATE HOLDER
<br />
<br />S8TTb Ana
<br />
<br />CA
<br />
<br />92701
<br />
<br />CANCELLATION
<br />
<br />IHOt.lIoJ;l """., 0,. n1E ABCM: Ufi5CRlBED POt.Il:::1!:81111!i CANCCt.lGD Dl<.f:Om THE UJIIIMTfON
<br />DAft 'THEReOF, THE ISIUING INSURER WI..... "1~IoInIII."UK .0 ~l. __ DAn WRITTt:N
<br />"'O'TICE TO TMI!: eIlWqIRI;ATf. HOLDliA ttFlMED TO n1E u;:n;'DDT'JI"AlUJ'RI!'Ttrtk,.. :tV 31'1ALL
<br />"lIIPD9E'""'ND~'T1ttII""'aR'1JIIaIIt.'TIT'b'-.wT1Cl'NIJ""D'l"DtrTMFIMID'R:ER~TTrXGI!flITS OR.
<br />.REPREm!:~.
<br />AU"HORKEQ REPFlE8liNTATlVE
<br />
<br />
<br />IOAC~D CORPORATION 'ORB
<br />
<br />City of SmtJI An.
<br />1000 E. SMH\Ana Rlvd.
<br />Suitt 200
<br />
<br />ACORD 2S (200"08)
<br />
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