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<br />ACORDTM CERTIFIC'....E OF LIABILITY INSURA"~E I DATE (MMlDDIYYYY) <br />10/18/2006 <br />PRODUCER Phone: (BOO) 747-9fi13 Fax: (303) 422-1276 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />The Camp Team ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />7615 W. 38Th Avenue, Unit 8-109 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Wheat Ridge CO 80033 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. <br />A-2007 -105-033 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED INSURER A: American Alternative <br />Orange County Youth Commission INSURER B: <br />1850 E. 17th Street #218 INSURER C: <br />Santa Ana, CA 92705 INSURER 0: <br /> INSURER E: <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOO 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 L1MrrS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR AOOl. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION liMITS <br />lTR NiR) DATE (MM/DDIYY) DATE (MMlDDIYY) <br /> GENERAL LIABILITY 76A2GLOOOOO1-01 10/2212006 10/2212007 l:ACH OCCURRENCE 1,000,000 <br /> X COMMERCIAL GENERAl lIABilITY ~~~~nco) $ 300,000 <br /> I CLAIMS MADE I X I OCCUR \.lED, EXP (Anyone person) Separate <br />A X INC ATHLETIC PARTICIPANTS ERSONAl & ADV INJURY 1,000,000 <br /> ~ENERAlAGGREGATE 2,000,000 <br /> IPRODUCTS-COMP/OP AGG. 1,000,000 <br /> POllC~ I;F~<;: I I LOC <br /> ~UTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> ANY AUTO Ea accident) <br /> All OWNED AUTOS COllY INJURY <br /> SCHEDULED AUTOS Per person) <br /> HIRED AUTOS BODilY INJURY ~ <br /> NON-<lWNED AUTOS Per accident) <br /> ROPERTY DAMAGE ~ <br /> Per accident) <br /> GARAGE L1ABIUTY AUTO ONLY - EA ACCIDENT <br /> ANY AUTO OTHER THAN EAACC <br /> IAUTO ONLY: AGG <br /> !exCESS 1 UMBRELLA LIABILITY lEACH OCCURRENCE $ <br /> OCCUR I I CLAIMS MADE GGREGATE <br /> S <br /> DEDUCTIBLE <br /> RETENTION $ <br />~RKERS CPMPENSATlON AND IWC STATU- I I nTLoCD <br /> MPLOYERS LIABILITY <br />~y PROPRlETORIPARTNERfEXECUTIVE ;;:L EACH ACCIDENT <br /> FFlCERlMEMBER EXCLUDED? .l. DISEASE-EA EMPLOYEE ~ <br />.. yes, describe und... <br />SPECIAL PROVISIONS below ,l. DISEASE-POllCY L1Mrr $ <br />OTHER: <br />DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTS/sPECIAL PROVISIONS <br />Youth Mentoring / California <br />Policy Deduclibles; $0_00 per each bodily injury / $500.00 per each property damage claim. <br />Additionallnsured(s): City Of Santa Ana, All participants, staff and facilities as scheduled with the company are added as additional insured in regards to <br />the operations of the insured. <br /> <br />CERTIFICATE HOLDER <br />City Of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br /> <br />.-oJ j-~....") <br /> <br /> <br />CANCELLATION <br /> <br />LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAlL 30 DAYS WRITTEN NOTICE <br />TO THE CERTIFICATE HOLDER NAMED TO THE LEF.T, BUT FAILURE TO DO SO SHAlL IMPOSE <br />NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, Irs AGENTS OR <br />REPRESENTATIVES. <br /> <br />Attention: <br /> <br />-~~<.~!./~~------ <br />~L ~~:7 -----.-"j <br /> <br />l:.'......;~..{....~~ \..:~;:~i /\t~Z";:-.~8~/ <br /> <br />-...~~ <br /> <br />Bob leid <br /> <br />ACORD 25 (2001/08) <br /> <br />@ACORDCORPORATION1988 <br /> <br />