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<br />", <br /> <br /> , - ~ A - ZOO - 0 l{ - os <br />ACQfJlJ. CeItfIFICA\.,; OF LIABILITY INSUI\.J"CeoMi':;~~ P1 DATE (MMlDDIYY) <br />OS/23/02 <br />PROD~CER 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 Fax:714-577-5888 INSURERS AFFORDING COVERAGE <br />INSURED INSURER A: PHILADELPHIA INDEMNITY 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 />5r <br /> <br />~ <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 POLICIES 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 />INSR TYPE OF INSURANCE POLICY NUMBER ~]:~ltrMie~b'iWYE Pd'Ik+~~~J~J.!RN 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 (Any OI1e fire) $100,000 <br /> I CLAIMS MADE [!] OCCUR MED EXP (Any O'le person} $ 5,000 <br /> ~ See below PERSONAL & ADV INJURY $1,000,000 <br /> f- GENERAl AGGREGATE $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/O? AGG $1,000,000 <br /> h ,nPRO- n <br /> POLICY JECT LOC <br /> ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 <br />A ANY AUTO PHPK022342 04/04/02 04/04/03 (Eaaccident) <br />f--- <br /> f--- ALL OWNED AUTOS BODrL Y INJURY <br /> $ <br /> SCHEDULED AUTOS (Per person) <br /> f--- <br /> ~ HIRED AUTOS BODILY INJURY <br /> . <br /> JC. NQN-OWNED AUTOS (Per accident) <br /> - PROPERTY DAMAGE $ <br /> (Peraccidenl) <br /> ~RAGE LIABILITY AUTO ONLY. EA ACCIDENT $ <br /> ANY AUTO OTHER THAN fA ACC . <br /> AUTO ONLY: AGG $ <br /> EXCESS LIABILITY APPR~JEI ASTOF pRM EACH OCCURRENCE $ <br /> ~-OCCUR D CLAIMS MADE ;::y ~ I/L AGGREGATE $ <br /> ~n . <br /> =J ,OEDUCTIBLE i::'allf.( Sheedy ( $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND --, I TORYUMITS I IV E.- <br /> EMPLOYERS' LIABILITY <br /> ~~. EACH ACCIDENT $ <br />, - E.l. DISEASE - EA EMPLOYEE S <br /> E.l. DISEASE. POLICY LIMIT $ <br /> OTHER <br /> *10 DAY CANCELLATION <br /> J'OR iroN' PAYKJ:N'T PRJ:NltIN <br />DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />City of Santa Anal 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 LETTER: CANCELLATION <br /> CISANBE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL MAIL ..J...a..!.. DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> City of Santa Ana-CDBG M-25 --- - -, <br /> Community Development Agency <br /> P.O. Box 1988 M-25 /'\ <br /> Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE 'j--" /1 (j_ Y 1/1)1 /'h IVJ" <br /> I Leslie A. McCarthv n;,-" '10 <br />ACORD 25-5 (7/97) Vi @ACORDCORPORATION1988 11 <br /> <br />~ <br />