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<br />ACOQ!)_ CERTIFICA TE OF LIABILITY INSURANC~Rgi~lH I DATE {MMlDOIYY} <br />. 06/04/03 <br />PRaOt'CER """ THIS CERTIFICATE. UED AS A MATTER OF INFORMATION <br />. ONLY AND CONFER o RIGHTS UPON THE CERTIFICATE <br />Huntington Pacific Ins. Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />18672 Florida St. Ste. 302D ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Huntington Beach CA 92648 INSURERS AFFORDING COVERAGE <br />Phone: 714-841-6283 <br />INSURED INSURER A: Great American Insurance CO. <br /> INSURER B: . - <br /> Mercy House Transitional INSURER C; 1T J'-1-1I?H7 -/(>'-;__ 7 J <br /> LivinR Center ETAL <br /> P.O. ox 1905 INSURER 0: <br /> Santa Ana CA 92702 <br /> I INSURER E: <br />- <br /> <br />\.uvr:i-<AGES <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 MAYBE ISSUED OR <br />MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LlMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />I~f~) TYPE OF INSURANCE POLICY NUMBER DATEIMMiDDrI?~t; I ",l'A"Ii~.l'~i6'6"rI?';" LIMITS <br /> ~~= EACH OCCURRENCE '1,000,000 <br />A X COMMERCIAL GENERAL LIABILITY PAC653621S 05/02/03 05/02/04 FIRE DAMAGE (Any Olle fire) .200,000 <br /> CLAIMS MADE ~ OCCUR MED EXP (Ivlyone person) '10,000 <br /> PERSONAL & ADV INJURY .1,000,000 <br /> , , , I uE~~RAlAGGREG~I~ S;:, :.~~, CCtJ <br /> ~ -- ---+- <br /> GEN'L AGGREGATE LIMIT APPLlES PER: PRODUCTS. GQMPfOP AGG .1,000,000 <br /> !xl ,nPRO- n <br /> X POLlCY JECT LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT '1,000,000 <br /> I-"- (Eaaccidenl) <br /> ANY AUTO <br /> f-- <br /> - ALL OWNED AUTOS 800rl Y INJURY . <br /> SCHEDULED AUTOS (Per person) <br /> - PAC653621S 05/02/03 05/02/04 <br />A ~ HIRED AUTOS BODILY INJURY . <br /> ~ NON.oWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE . <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY. EA ACCIDENT . <br /> R ANY AUTO OTHER THAN EA ACe . <br /> APPROVED AS Tu r-u '- ~ ~. AUTO aNt Y: AGG . <br /> EXCESS LIABILITY ~j EACH OCCURRENCE . <br /> b OCCUR D CLAIMS MADE vi, AGGREGATE . <br /> Laur11 ShL~.. dy OJ'ht . <br /> . <br /> R DEDUCTIBLE P.,puty CilY At <br /> RETENTION . . <br /> I WORKERS COMPENSATION AND I ;'ocRW~I"Y-iS I IU~;;- <br /> EMPLOYERS' LIABILITY E.L. EACH ACCIDENT . .. <br /> , I Li._ DISEASE - [,.., .....i.., :'::;":":::i ... <br /> -- - - - <br /> I I e, L DISEASE. POLICY L1MrT I $ <br /> OTHER <br /> I <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDEO BY ENDORSEMENTISPECIAL PROVISIONS <br />I\'ith respects to the additional insureds, this insurance shall not be <br />cancelled or materially reduced in coverage or limits except after (30) days <br /> written notice has been given to the City of Santa Ana. <br /> C':-',,:-'~:j':-'r; .>i;-' ;'q:-,-: n~'-i <br /> -".'-' --p-.'... -'-.'--...-- <br /> <br />City of Santa Ana, Community <br />Development Agency M-25 <br />Att: John Maloney <br />P.O. Box B88 <br />Santa Ana CA 92702-1988 <br /> <br />I y I ADDITIONAL INSURED; INSURER LETTER: <br />SANTANA <br /> <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ~'!f""' fe MAlL ~ DAYS WRITTEN <br />NonCE TO THE CERTIFICATE HOLDER NAMED laTHE lEFT, ~ rjrfJJrt...".. Raf-. r~ <br />pfif~r;IJ''''ft~JlBfl~~ 'rO'fTrJ"'I"rpf+I#sM <br /> <br />CERTIFICATE HOLDER <br /> <br />I <br />ACORD 25-S (7197) <br /> <br />AUTHORIZED REPRESENT~~E <br />Don Heberden 1JJ(/'tV <br /> <br /> <br />~ <br />@ACPRDCORPORATION 1988 <br /> <br />4-),."J."r. __ <br />