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<br />ACORD. CERTIFICATE\...JF LIABILITY INSURANCbJ <br />(949)709-'800 FAX (949)709-166' <br />COoprehensive Insurance Services <br />22S42 Avenida Empresa <br />Suite 200 <br />RSIII, CA 9261. <br />-.. Assistance League of Santa Ana I OJ..... .........k <br />1037 W. First St....t \(Jf 'J <br />Santa Ana. CA 9270S 0'.,1',- ~ <br />1,. ',,} , <br />\> <br /> <br />From: COfl1lrehensive Insurance 949-709-1688 To: Cesar Cedeno <br /> <br />- <br /> <br />COVERAGES <br /> <br />Date: 1012812002 Time: 12:27:22 PM <br /> <br />Page2of3 <br /> <br />I DATE (IMDDIYV) <br />06/U/2002 <br />TIllS C~~~~TE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY ANO CONfERS NO RIGIlTS UPON TIE CER11F1CATE <br />HOlDER. TIllS CElmFICATE ODES NOT AlIENO. EXTEND OR <br />ALTER THI! COVERAGE AFFORDED BY THe POLICIES BELOW. <br /> <br />INSUIlEIlS AFFOROtNG COVERAGE <br /> <br />NONPRDFm' DlSUIlANCE ALLIANCE <br /> <br />........... <br />tNSUREFl c; <br />JNSUAER D: <br />........ ~ <br /> <br />T11E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TIE INSURED NAMED ABovE F~ THE POLICY PERIOD IN)ICA.TEO. NOTWITHSTANDING <br />~y REQUtREUENT. TERM OR CON>ITfON OF NI'f CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WI-ICH nus CERTIFICATE IMY BE ISSUED OR <br />IMY PERlAIN, THE O\ISlMlANCE AFFORDED BY ~E POlICIES DESCRIBED HEREIN IS SUB.ECl TO ALL ~E lERMS, EXCl.USIONS ANe CONDITIONS or SUCH <br />POlICES AGGREGATE LIMITS SHOW!< MAY HAVE BEEN REOUCEO BY RAI) ClAIMS. <br /> <br />1m' ~7::m--' 002_075;;:''';;;-' ~ ~ EACHoccURAENCE LINITTl. <br />.!. ~RCW.l:itNE~Ll"BLITY <br />_ --.J ClHYS MADE [!] OCCUR <br />A <br /> <br />~lAGGR~LIMIT~ PER; <br />I POlICY I I~l lux <br />~1'OIIOaILI' LiAIIUTY <br />~Nf'(~O <br />r- AllOWNEOAUTOS <br />t--- SCHEOULEO AUTOS <br />_ HMD AUTOS <br />_ NCJN.CJWNED AUTOS <br /> <br />~QI! L....ITV <br />I Nf'( NJTO <br /> <br />EXCElS UA8IUJY <br /> <br />::::rocwo 0 ClAlM8lWl. <br /> <br /> <br />f DEtxJCTaE <br /> <br />I RETENTION S <br /> <br />WOfIlCPI CClllltNSAflON AND <br />EMPLO'fEM" LIA8IUTY <br /> <br />FIRE DAMlWE (Any Q!'lt..... I <br />MEDEXP(AtlyOfltl*lOlll . <br />PeRSONAl. & KJV INJURY . <br />CENERAL.AGGREOATE . <br />P~T!. OOMPJOP ACG . <br />COMe/NED SINGLE: UMIT I <br />llMlIOOid8niJ <br />BOOL V INJURY I <br />(......JIftQl1) <br />80DIL v IlUURV . <br />(PM'ICICidMlI) <br />PRQP!RTV DIoMAGE . <br />(PelT .utltnt) <br /> <br />1 000 OCMI <br />100~ <br />10.ood <br />1 ooo.ood <br />S,OOO._ <br />S.OOO.ODd <br /> <br />AUTO ON... Y . EA ACCIDBfT $ <br />EAACC $ <br /> <br />OTHER T~ <br />AVTO ONlY <br /> <br />AGG S <br />I <br /> <br />E4CW OCCURRENCE <br />AGGREGATE <br /> <br />AP~lhvn T& FORNI <br /> <br />,.. 1- <br />CRISTI tl E SHAW <br />Deputy City Attorney <br /> <br />. <br />. <br />I <br />. <br />I lORY I.MlS I I"'~. <br />E.L. EACIi ~C1DeNT , <br />E.L DISEASe - EA EMP\OVIi I <br />E.L. DISEASE - POLICY LMT S <br /> <br />OTHeR <br /> <br />DEICRPTION OF OPERAlWJIIIILOCATIONINBtICLRIIXCLU8IOft8 ADDIO'" IIlDOMell!NTIlPECIAL PRCMIIOQ <br />E: FUNlING <br />10 DAY NOTICE SIIOULO TllE POLICY CANCEL FOR NlIN-PAVIIENT <br />:ERTIFICATE HOLDER IS NIIIlEO AS ADDITIONAL INSURED PER THE ATTACHED SPECIAL ENIlORSIIENT <br />EPLACING ORIGINAL CERTIFICATE ISSIIEO OH 6/7/02 <br /> <br />CER1lFICATE NOLDER I 1....TllllMl. .....11> ,_RL......., <br /> <br />CI1Y Of' SANTA ANA <br />ClMtlNm DEVELlIPEMENT AGENCY <br />Il-Z5 <br />P.O. BOll 19.. <br />SANTA ANA. CA 92702 <br /> <br />_Zil-S(7117) FAA. (714)647-6580 <br /> <br />CMlCELLAnON <br />MlOUI.D Nlf Of TN! MOVE DESCRlIEO POUCIQ BE.....-. I en. HFOlU TIE <br />UPIItATIOII OAT! THEREOf, THE..UIIG COMPANY WILL MlUI:'UM'lIlAlL <br />~ DAY8WRITT!N NOTICE TO TI1E ClRTW'ICATE HOLDER NIWID TO THE LIFT. <br />IllIllIOOlIIU_---WCIIllIll.......y..flll...-XX <br />_7IIlI1IlIlII4WI~m.'llllalllIOIl(.' ..............-xxxxxxxx <br />AUTHOItlZ!D IIt!PIlHINTATMJ ....-. <br />Richard EVIWl. CIC/BRANOI ..;~.(?- <br /> <br />Nl'" <br />