My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
CAMBODIAN FAMILY, THE 8 - 2002
Clerk
>
Contracts / Agreements
>
C
>
CAMBODIAN FAMILY, THE 8 - 2002
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
1/3/2012 3:07:55 PM
Creation date
4/13/2006 3:03:47 PM
Metadata
Fields
Template:
Contracts
Company Name
Cambodian Family, The
Contract #
A-2002-105-07
Agency
Community Development
Expiration Date
6/30/2003
Insurance Exp Date
3/9/2003
Destruction Year
2011
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
24
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
<br />ACORD CERTIFICATJ: OF LIABILITY INSURJ\ NeE <br />~ <br /> <br />DATE (MMJDDlYYj <br />03/11/2002 <br /> <br />PROOUCER (626) 599-8830 FAX (6 <br />Pacific General Insurance Services <br />405 E. Santa Clara Street <br />Suite 100 <br />Arcadia, CA 91006 <br />INSURED The Ca od an Fam y <br />1111 E. Wakeham Avenue <br />Suite E <br />Santa Ana, CA 92705 <br /> <br />599-8831 <br /> <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 POLICIES BELOW. <br /> <br />INSURERS AFFORDING COVERAGE <br /> <br />Philadelphia Indemnity Ins. Co <br /> <br />\olyA) <br />{I/' <br />/1A> <br /> <br />INSURER A: <br /> <br />INSURER B: <br />INSURER c: <br />INSURER 0: <br />INSURER E: <br /> <br />Revised as of 09/11/02 <br /> <br />COVERAGES <br /> <br />THE POLICIES 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 DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN. THE INSURANCE AFFORDED BY THE PDLlCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS ANO CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE seEN REDUCED BY PAID CLAIMS. <br /> <br />DATE (MM/DDIYY) <br />03/09/2002 <br /> <br />OX!f'E (MMfDOIYY) <br />03/09/2003 <br /> <br />LIMITS <br />EACH OCCURRENCE S <br />FIRE DAMAGE (Anyone fire) $ <br />MED EXP (Anyone person) $ <br />PERSONAL & ADV INJURY $ <br /> <br />GENERAL AGGREGATE S <br />PRODUCTS. COMP/OP AGG S <br /> <br />1 000 000 <br />100 000 <br />5,000 <br />1,000,000 <br />3.000,000 <br />1 000,000 <br /> <br />03/09/2002 <br /> <br />03/09/2003 <br /> <br />COMBINED SINGLE LIMIT <br />(Ea acCident) <br /> <br />. <br /> <br />1,000,000 <br /> <br />BODILY INJURY <br />{Per person) <br /> <br />. <br /> <br />BODILY INJURY <br />(PeracclC:entJ <br /> <br />. <br /> <br />PROPERTY DAMAGE <br />(Peraccidenl) <br /> <br />GARAGE LIABILITY <br />R ANY AUTO <br /> <br />EXCESS LIABILITY <br />=.J OCCUR 0 CLAIMS MADE <br /> <br />I DEOUCTIBLE <br />I RETENTION $ <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br /> <br />AUTO ONLY. EA ACCIDENT S <br /> <br />EACH OCCURRENCE <br />AGGREGATE <br /> <br />EA ACe s <br />AGG S <br />. <br />. <br />, <br />. <br />. <br /> <br />OTHER THAN <br />AUTO ONLY: <br /> <br />I TORY LIMIT' I I'ER <br />E.L. EACH ACCIDENT $ <br />E.:". DISEASE. EA EMPLOYE $ <br />E1. DISEASE. POLICY LIMIT S <br />OTHER ~HPK020993 03/09/2002 03/09/2003 STA & 500/1000 comp/coll Deduc <br />Auto Physical Damage ~HPK020993 03/09/2002 03/09/2003 $121,000 & 500 Deductible <br />A Bus Pers Prop/Prof <br />Liabil PHPK020993 03/09/2002 03/09/2003 $1,000,000 <br />DESCRIPTION OF OPERATIONS/LOCAT10NSNEHICLESfEXCLUSIONS ADDED BY ENDORSEMENTfSPECIAL PROVISIONS APPRO V E ' AS TO FORM <br />SCHEDULE OF VEHICLES & DRIVERS: ON FILE <br />ERTIFICATE HOLDER IS NAMED ADDITIONAL INSURED PER EXHIBIT G ATTACHED. ~ LJ . <br /> <br />OL~ <br />j[, a Sheedy <br />TEN DAY N.D.L SHALL BE GIVEN IN THE EVENT OF NON-PAYMENT OF PREMIUM. Oeputy City Attorney <br /> <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELL.ED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANYWILL~~ MAIL <br />-3.0.- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE L.I:FT. <br />kWll*KllIIIlOOlll9l)oo;KK~~IlXK!OOIlIltll1J1.O(~KllXXX <br />It!(~ltKlQlflOOlIJ{!QlOXIXl(~JUliOOfl(Jq){l(XXXXXXXX <br />AUTHORIZED REPRESENTATI't:.....n... . . . _ . <br />Michael Mart"in - / rJ.-J-J1-./ /,Vi. u.-i/C "-- <br /> <br />CERTIFICATE HOLDER <br /> <br />I X I ADDITIONAL INSURED; INSURER LETTER: A <br /> <br />City of Santa Ana <br />Its' Officers, Agents & Employees <br />CDGB M-34 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br /> <br />" <br /> <br />'''''/- <br />
The URL can be used to link to this page
Your browser does not support the video tag.