|
<br />l
<br />
<br />') -
<br />
<br />.....
<br />
<br />4F1!-.?u02 - 013 /5
<br />
<br />ACO@. . CERTIFICA'~ OF LIABILITY INSUF\..NC~si';l~ m1 DATE {MMtDDfYV)
<br />- :01/17/03
<br />-.
<br />l~UCER THIS CERTIFICATE IS ISSUED AS A MA ITER OF INFORMATION
<br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />dvanced Insurance Marketing HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />.0. Box 4459 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />range CA 92863-4459 INSURERS AFFORDING COVERAGE
<br />hone:714-997-8100 .- -
<br />5UREO INSURER A: Philadelphia Indemni tv Ins CO.
<br /> INSURER B:
<br /> Wiseplacer a Ca Corp INSURER c:
<br /> 1411 N. Broadwa1 INSURER 0:
<br /> Santa Ana CA 92 06
<br /> I INSURER E.
<br />
<br />JVERAGES
<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 />',.lAY PERTAIN, THE INSURANCE AFFORDED BYTHE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />;:i TYPE OF INSURANCE POLICY NUMBER b~W:C7Mif,b~~E Pr?A~~~~~~m?N LIMITS
<br />LGENERAl LIABILITY EACH OCCURRENCE '1,000,000
<br />. rxl COMMERCIAL GENERAL llABIUTY PHPK039141 01/01/03 01/01/04 FIRE DAMAGE (Anyone fire) , 100,000
<br />ITI CLAIMS MADE ~ OCCUR MEa EXP (Anyone person) -'-.1_~,<U>Q___1
<br />~- .. ...------
<br /> PERSONAL & ADV INJURY , 1,000,000
<br />, GENUGG~nE ;;:'~T APnS PER GENERAL AGGREGATE '2,000,000
<br /> PRODUCTS - COMP/OP AGG '2,000,000
<br /> POllCY JECT LOC ..
<br />~TOM081LE LIABILITY COMBINED SINGLE LIMIT ,
<br />~ ANY AUTO PHPK039141 01/01/03 01/01/04 (Eaacddent)
<br />C- ALL OWNED AUTOS BDDIL Y INJURY , 1,000,000
<br /> SCHEDULEO-AUTOS (Per person)
<br />I--
<br />I-- HIRED AUTOS BODILY INJURY
<br /> (Per accident) ,
<br />I-- NQN-DWNED AUTOS
<br />I-- PROPERTY DAMAGE ,
<br /> (Per accident)
<br />RRAGE LIABILITY AUTO ONLY. EA ACCIDENT ,
<br /> ANY AUTO OTHER THAN EA ACC ,
<br /> I AUTO ONLY: AGG ,
<br />~CESS LIABILITY EACH OCCURRENCE , 1,000,000
<br /> X OCCUR 0 CLAIMS MADE PHUB015081 01/01/03 01/01/04 AGGREGATE '1,000,000
<br />I ,
<br />f;:j DEDUCTIBLE ,
<br /> X RETENTION , 10,000 ,
<br />i WORKERS COMPENSATlON AND APPi~OVEl l\S -10 I" bRM I TORY llMrrsl IU~~-
<br />, EMPLOYERS' LIABILITY
<br />I ~.l. EACH ACC.IOENT ,
<br />I ,i%J~ft
<br />I , ri!~ E.L DISEASE - EA EMPLOYE ,
<br /> 7?f. E.L DISEASE - POLICY LIMIT ,
<br />I OTHER LaUfi.! :)lJl"<.:Jy (
<br /> I DepulY City ^,ll()rncy i
<br /> i i
<br />SCRIPTION OF OPERAT10NS/lOCATIONSNEHICLESJEXCLU510NS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
<br />en Day Notice of Cancellation for non-payment/non-reporting/ The City of
<br /> , 1 r are named as
<br />
<br />~nta Ana, 1t s off1cers. agents, employees, and vo untee s
<br />jditional insured per attached Additional Insured Endorsement.
<br />
<br />cRTIFICATE HOLDER
<br />
<br />i y I ADDITIONAL INSURED; INSURER LETTER:
<br />SANTAAN
<br />
<br />CANCELLATION
<br />
<br />CITY OF SANTA ANA COMMUNITY
<br />DEVELOPMENT AGENCY M-25
<br />MICHAEL GARCIA
<br />P.O. BOX 1988
<br />SANTA ANA CA 92702-1988
<br />
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAT!O
<br />DATE THEREOF, THE ISSUING INSURER WILL MAll ~ DAYS WRITTEN
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT,
<br />
<br />AUTHO
<br />~~
<br />
<br />E
<br />
<br />ATIVE
<br />
<br />:ORD 25-S (7/97)
<br />
<br />@ACORD CORPORATION 1988
<br />
|