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<br /> - . . A -2-00 -=e~L( 0 <br />; A'tORD. C'l::R~;'[']()"'(T^'" OF LIABILITY [ .-- - <br />- &....R NeE; OPIO P] DATE (MMlODiYY) <br /> OMEN - 3 OS/23/02 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> ISU Ins Srv - Fullerton Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 1150 E Orangethorpe Ave,#lOl ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Placentia CA 92870 <br /> Phone: 714-577"5800 FaxI714-577-5888 INSURERS AFFORDING COVERAGE <br /> iNSUReD INSURER A: PHILADELPHIA INDEMNITT INS. CO <br /> INSURER B: <br /> Women's Transitional Living INSURER c: <br /> Center <br /> P.O. Box 6103 INSURER 0: <br /> Orange CA 92863 <br /> I INSURER E: <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOve FOR THE POLlCY PERIOD IND!CATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFlCA TE MAYBe ISsueD OR <br />f.1A Y PERTAIN. THE INSURANce AFFORDED BY THE POLICIES OESCRiBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN r.1AY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR TYPE OF INSURANCE POLICY NUMBER ';~f~lM'f.t6'f,\W:" I ~}~~~~~r1v"?N LIMITS <br />LTR <br /> ~NERAL LIABILITY EACH OCCURRENCE $1,000,000 <br />A X COMMERCIAL GENERAL LIABILITY PHPK022342 04/04/02 04/04/03 FIRE DAMAGE (Ally one fire) $100,000 <br /> I CLAIMS MADE [!] OCCUR MED EXP (Any cr:e persof\~ $ 5,000 <br /> ~ See below PERSONAL & AOV INJURY $ 1, 000, 000 <br /> - GENERAL AGGREGATE $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPlS :ER: PRODUCTS. COMPtOP AGG .1,000,000 <br /> II .nPRD- <br /> POLICY JECT LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> - .1,000,000 <br />A ANY AUTO PHPK022342 04/04/02 04/04/03 (Eaaccident) <br /> - <br /> ALL OWNED AUTOS BODILY INJURY <br /> - $ <br /> SCHEDULED AUTOS (Per person) <br /> - <br /> ~ HIREOAUTOS BOOIL Y INJURY <br /> $ <br /> ~ NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE $ <br /> (Peraccidenl) <br /> ~DE LIABILITY AUTO ONLY. EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA Ace $ <br /> AUTO ONLY; ADD $ <br /> EXCESS LIABILITY AP~JE AS TO F )RM EACH OCCURRENCE $ <br /> =:J OCCUR D CLAIMS MACE ~ //2- AGGREGATE $ <br /> A~" $ <br /> =j ~EDUCTI8LE }!auf:( Sheedy 7 $ <br /> RETENTION $ $ <br /> I WORKERS COMPENSATION AND ..,-r: I 'rOcR~',')~'YTSI IU~,\'. <br /> EMPLOYERS' LIABILITY E.l. EACH ACCIDENT $ <br /> I E.L. DISEASE. EA EMFLOYEE S <br /> E.L. DISEASE. POLICY LIMIT S <br /> OTHER <br /> *10 DAY CANCELLATION <br /> 'OR NON PA't')(XN'I' PJl,IlUO'K <br />DESCRIPTION OF OPERATlONS/LDCATlONSNEHICLEStEXCLUSIONS ADDEO BY ENDORSEMENT/SPECIAL PROVISIONS <br />City of Santa Ana, its officers, agents employees and volunteers are named <br />as additional insured as respects to their interest in connection with the <br />named insured. Addit'l insured as respects to general liability per form <br />attached to pol. This pol is primary & is not additional to or contributing <br />w/ any other insurance *except for gross negligence and willful misconduct. <br />CERTIFICATE HOLDER I y I ADDITIONAL INSURED; INSURER LETTE.R: CANCELLATION <br /> CISANBE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPiRAT <br /> DATE THEREOF, THE ISSUING INSURER WILL MAlL ~DAYSWRITTE <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ft.~ <br /> City of Santa Ana-CDBG M-25 - - -.. . .~_' __ r..:::.. <br /> Community Development Agency - /I, , <br /> P.O. Box 1988 M-25 <br /> Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE )'---'"' IJ (J. Y -)(\:~ <br /> I Leslie A. McCarthv n,,u, '] P ,r kll ',j)L <br />ACORD 25.S (7/97) V -;' @AC(fRDCORPORATION198' <br />