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<br />From: Chapman Cert Request At: Chapman Insurance FaxlD: Chapman Associates To: Laura Sheedy
<br />-
<br />
<br />Date: 4/26/2007 03:53 PM Page: 3 of 5
<br />
<br />ACORD~
<br />
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />
<br />DATE (MM/DDIYYVY)
<br />
<br />BL~-l 04 25 07
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATlO
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELO
<br />
<br />
<br />PRODUCER
<br />Chapman & Associates
<br />License '0522024
<br />P. O. Box 5455
<br />Pasadena CA 91117-0455
<br />Phone: 626-405-8031 Fax:626-40S-0585
<br />
<br />
<br />INSURED
<br />
<br />A-2007 -105-003
<br />
<br />INSURERS AFFORDING COVERAGE
<br />",SURER.A J?!1il~delphia In~ity
<br />N5URER R
<br />'NSURE,' C
<br />INSURE,' D
<br />INSURER E
<br />
<br />NAIC#
<br />
<br />The Blind Childzen's Lear.Binq
<br />cente:r
<br />18542 vanderlip Ave., #B
<br />Santa Ana CA 92'705
<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 REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO II\oI-IICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSUR.ANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES, AGGREGATE LIMITS SHO'M'l MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />,...~" NSRI TYPE OF INSURANCE POLICY NUMBER PD~1,fe iMM/DDJYYI- P6'kk MMIODl'fY LIMITS
<br />LTR
<br /> GENERAL LIABILITY EACH ('I~CUPRE="N(,F I> 1000000
<br /> -
<br />A ~ ':OMMERCIAL GENERAL LIABILITY PHPIU96155 10/16/06 10/16/0'7 u~'" , " ~rr" I rl' !l 100000
<br /> tJ ~LAIMS MADE ~ OCCUR PREMI:::E~~ ;E~H'Cc.uro:-ni:8)
<br /> - MED ['::F' (Ani .)ne ~';;,r;,:'riJ .,5000
<br /> PEt=.'::;,'}~,I,c..:.. SAL...... INJ)~''i ~$ 10QOOOO __
<br /> - - _._~,.
<br /> GEt-lEF.',b,l A(~'_..,RE'~~ATE i > 2000000
<br /> -- -- -.. -_..~~-
<br /> _':5N"'. ,"-GG~EnE LIMIT APPlS PER PROE"XT:, ':':'MF'!':'F A:,(, $ 2000000
<br /> ------ . ,-- ,
<br /> -1 PRO- EmD Ben. ' ~OOOOOO
<br /> POLICY JECT LOC
<br /> AUTOMOBILE LIABILITY COt~8INED :3Ir~GlE ... if,.' i-
<br /> - ; 1000000
<br />A ~ ANY AUTO PHPIU96155 10/16/06 10/16/07 (Ea a':oji'~t)
<br /> AlL OIM'JED AUTOS BOCtlL:' IhJ...tl~"(
<br /> I-- :$
<br /> &CHEDULEDAUTOS {p",r ~'.:.rs(n, i
<br /> I--
<br /> ~ HIRED AUTOS BOD:L"Ir,.-'JI."f
<br /> ~ NON-OVl.NED AUTOS (Pel ~l'~Hjimt) i >
<br /> f-.- +...~- PRClFEPT"T :)A.t...1.A,GE ,
<br /> (Per (l1)J'.I':l!Il)
<br /> I GARAGE LIABILllY AUT :~I ,'-,t'H, " FA AI-,- DFNT : f.
<br /> h .ANY AUTO EAfo,I:": \ t
<br /> f---, OTHEP THAi~
<br /> i AUT(I,:'Nl Y ,....,:~':, f.
<br /> EXCESS,uMBRELLA UABILITY EACH l:lI:CURRENCE !$2,000,000
<br />A ~ OCCUR o CLAIMS MADE PHUBO'72451 10/16/06 10/16/0'7 AGG~:E'~~:'l C 1>2,000,000
<br /> ,
<br /> ~ -... j t -. ---.
<br /> ~ DEDUCTIBLE
<br /> X RETENT ION $10,000 1 $
<br /> \I\IORKERS COMPENSAnON AND IT;~~7/~I~lrfs I u f ~
<br /> E,'
<br /> EMPLOYERS' UABILITY i >
<br /> ANY PROPRIETORJ?ARTNERIEXECUTlVE E.L EAr:H kl:': IDENl
<br /> OFFICER/MEMBER EXCLUDED? EL [,C,U;[ - Ef',CMFc';'YCt $
<br /> If yes. desaitle under
<br /> SPEC",,- PR')VISIONS below E.L [o1:'E.AS E - P':'U( 'f lIM IT ~ f
<br /> OTHER
<br />A Crime PHPIU96155 10/16/06 10/16/0'7 ..~ "? .-:J "/ .c~ iJ ;~0 r""rn F\ )RM
<br /> - .. ..l '_J DESCRIPTION OF OPERAnONS I LOCAnONS IVEHlCLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS r~.J L . /, Is
<br />The City of Santa Ana, its officers, enployees, agents, volunteers and -;;z::~' I b /
<br />representatives are named additional insured with respect to the operat:ions - ".~;--,'---.-:-;-;-c:: (..;, ,-
<br /> . "-',....:.~u. ~l.... -J.-.....""'"'u.f
<br />of the named l.nsured per the attached CG 2026 endorsement. Such insurance is," ".. ,.;. A" -,"n
<br /> .-'~~')':':-i1.~_..1!" L...lY dlC:,
<br />primary and non-contributory. 10 days notice of cancellation for non-payment
<br />of premium. This replaces certificate issued 04/24/07
<br />
<br />CERTIFICATE HOLDER CANCELLATION
<br />
<br />The City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92'701
<br />
<br />CITY -11 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATlO
<br />DATE THEREOF. THE ISSUING INSURERV\IILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL
<br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
<br />REPRESENTATIVES.
<br />AUT REPR
<br />
<br />ACORD 25 (2001108)
<br />
<br />@) ACORD CORPORATION 1988
<br />
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