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<br />ACORD
<br />'"
<br />
<br />I PATE (MMlODIYYYY)
<br />
<br />01/31/2006
<br />
<br />THIS CERTIFICATE J~ !!lSUED AS A MATTER OF INFORMATION
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY-THE POUCIES BELOW_
<br />
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />
<br /> THE POUCIES 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 DOC\JMENT WrTH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISS\JED OR
<br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL mE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
<br /> POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />I TYPE OF INSURANCE POl.lCY NUMBER DATE.(MMlDD DATE MM1D~ UMITS
<br />LTR NSR
<br /> GENERAL LIABILITY PHPK156499 01/30/2006 01/30/2007 EACH OCCURRENCE , 1,000,000
<br /> 7 COMMERCIAL GENERAL LIABILITY PREMISES EB oa::.urence' $ 100 000
<br /> I CLAIMS MADE [!] OCCUR MED EXP (Any ene parsOl1) , 5,000
<br />A X PERSONAL & ADV INJURY , 1,000,00
<br />I--
<br /> GENERAL AGGREGATE , 3,OOO,00fi
<br /> I--
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 3,000,00fi
<br /> Xl POLICY n ~G€r n LOC
<br /> AUTOMOBILE LIABILITY PHPK1)6499 01/30/2006 01/30/2007 COMBINED SINGLE LIMIT
<br /> X ANY AUTO (Eaaccldenl) $ 1,000,000
<br /> ...:.:.. ALL OWNED AUTOS
<br /> - BOOIL Y INJURY ,
<br /> SCHEDULED AUTOS (Per person}
<br />A X -
<br /> HIRED AUTOS BODILY INJURY
<br /> - $
<br /> NON.OWNED AUTOS (Peraccldenl)
<br /> -
<br /> - - PROPERTY DAMAGE $
<br /> = fC"': > (Peraccidenl)
<br /> GARAGE UABILlTf i\ft.D }\~ ~-- AUTO ONLY. EA ACCIDENT $
<br /> =l ANY AUTO .,.,t'~(? {, . OTHER THAN EAAGe ,
<br /> t>> :..J.. . AUTO ONLY: AGG $
<br /> BESS/UMBRELLA LlABIUTY /.' ..S F>-ttOlne~ EACH OCClIRRENCE ,
<br /> OCCUR 0 CLAIMS l4ADE \-\SF>- Cit' AGGREGATE $
<br /> ~S\st3nt ([ o.f ~) ,
<br /> R DEDUCTIBLE ,
<br /> RETENTION , ,
<br /> WORKERS COMPENSATION AND I TORY LIMITS I IV,,"
<br /> EMPLOYERS'LlABIUTY
<br /> ANY PROPRIETORlPARTNERlEXECUTlVE E.L. EACH ACCIDENT ,
<br /> OFFICERlMEMBER EXCLUDED? E.L. DISEASe - EA EMPLOYEE .s
<br /> If yes, describe under
<br /> SPECIAL PROVISIONS below E.L DISEASE. POLICY LIMIT ,
<br /> OTHER PHPK156499 01/30/2006 01/30/2007 See Below
<br /> rime Coverage
<br />A Professional Liability PHPK156499 01/30/2006 01/30/2007 $1,000,000 acC/$3,000,000 acc
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSJONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
<br />ity of Santa Ana, its officers, agents and employees are named as additional insureds with
<br />~espects to all operations by the named insured for general liability only as a funding SOUrce.
<br />~ ten day notice of cancellation shall be given in the event of non-payment of premium
<br />
<br />PRODUCER (626)599-8830 FAX (626)599-8831
<br />Pacific General Insurance Services
<br />405 E. Santa Clara Street
<br />Suite 100
<br />Arcadia, LA 91006
<br />INSURED Mexican Amerlcan Opportuni ty Foundation
<br />401 N. Garfield Avenue ,t. ruU'f-I') f :? Dr
<br />Montebello, CA 90640
<br />/r ~"'?"1...!it-. 1.1..5"- /I.... ~v0'1
<br />,1- .? u of' - / k'", J -,.} '" 0' ~--
<br />
<br />_ .)v'1
<br />07 ('. V~'f'
<br />
<br />COVERAGES
<br />
<br />CERTIFICATE HOLDER
<br />
<br />City of Santa Ana/Fez Daisy Wheel Network
<br />Santa Ana Work Center
<br />Attn: Rea Gonzalez
<br />1000 E. Santa Ana, Suite 200
<br />Santa Ana, LA 92701
<br />
<br />ACORD 25 (2001/08) FAX: (714) 565 2602
<br />
<br />INSURERS AFFORDING COVERAGE
<br />
<br />INSURER'" Philadelphia Indemnity
<br />INSURER B:
<br />INSURE.R c:
<br />INSURER D:
<br />INSURE.R E:
<br />
<br />NAIC#
<br />
<br />Insurance Company
<br />
<br />CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLlCIES BE CANCELLED BEfORE THE:;
<br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ~ MAIL
<br />-...3.!l...- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
<br />
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