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pate: 1128/2007 02:26 PM Sender's Fax ID: <br />ACORD,. CERTIFICATE OF LIABILITY INSURANCE <br />(OC) Heffernan Insurance BrkrzA-2008-069-64 <br />1855 Katella Ave, Suite 255 <br />Ora -go cA 92867-4d59 <br />Phone. 714-997-8100 Fax: 714-997-1994 <br />-AT'i WWDDf;'.' , <br />THIS CERTIFICATE IS ISSUED ASa A MATTER OF IMPOR lATTON <br />ONLY AND CONFERS NO RIGHTS UPON THE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, E (TEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW <br />INSURERS AFFORDING COVERAGE NAiC <br />INSURERA: Philadelphia lndcsmit- _ <br />INSURERS: - - <br />Teen Challenge Of SO. Ca. Inc - <br />INSURER C: _ <br />5445 Chicaggo Avenue <br />Riverside CA 92507 <br />INSURERD: <br />INSURER E <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDINt- <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 SJC <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />_ <br />LTR TYPE OF INSURANCE POLICY NUMBER <br />DATE AMID DATE 1DDIYY) LIM -S <br />OENFJiALL1APR.IIY <br />EACH OCCURRENCE <br />A XS COMMERCIAL GENERAL LIABILITY PHPK248830 <br />07/19/07 07/19/08 PREMISES (Eso-xirerw <br />300, OAC <br />CLANS MADE ® OCCUR <br />MED EYP (Inv in oe. o <br />; �3 f 000 <br />PERSONALaADV:NjL;P <br />1,000,000 <br />GENERAL AGGREGATE <br />:: 1 , 000 , 00!D <br />OWL AGGREGATE LIMIT APPLIES PER <br />i -PRODUCTS-COMPJOPtiGC. <br />52,000.004 <br />POLICY SENT LOC <br />Ben • <br />1,000,000 <br />AUTOMOBILE <br />UABIUTYCOMBINED <br />SINGLE L IMI- <br />000 . 0001 <br />A <br />ANY AUTO <br />PHPK248830 <br />07/19/07 <br />07/19/06 (Eaaccaer:N <br />i <br />ALL OWNEDAUTOS <br />I <br />BODILY INJURY <br />(Per perunt <br />$ <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />BODILY INJURY <br />NON -OW NEE AUTOS <br />_ (Per accident-. <br />- <br />PROP ERT'! DAMAGE <br />- <br />(Per aocideni) <br />GARAGE LJABII ITY <br />!AUTO ONLY - EF. ACCIDENT <br />ANY AUTO <br />OTHER THAN FA ACC <br />AUTO ONLY AG <br />EX ZWOMBRELLALUMLITY <br />I EACH OCCURRENCE <br />:,9,000,000 <br />` <br />A <br />x OCCUR CLANISMADE <br />PHUB090799 <br />07/19/07 <br />07/19/08 1 AGGREGATE <br />DEDUCTIBLE <br />g RETENTION s10,000 <br />WORKERS COMPENSATION AND <br />a J <br />L TORY LIMITS ER <br />_ _.. _..— _._._. <br />_ <br />EMLPOYERS' LIABILITY <br />E.L. EACH ACCIDENT <br />-. <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />- - <br />OFFICERMEABER FPXCLUDED? <br />E.L. DISEASE - EA EMPLOYE:; <br />Myyr� deatxIDaunder <br />SPEPROVISIONS belay <br />------.---._._—_. __ <br />E.L DISEASE -POLICY _ M! <br />---- <br />DESCRIPTION OF OPERATIONS! LOCATIONS t VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECWL PROVISIONS <br />The City of Santa Ana, its officers, employees, agents, volunteers and <br />representatives are named as Additional Insured with regard to General <br />Liability. RE: CDBG Grant <br />CERTIFICATE HOLDER CANCELLATION <br />CITSAW SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAT!0 <br />DATE THEREOF, THE ISSUING INSURER WALL ENDEAVOR TO IVA:_ DAYP 1R -: F <br />NOTICETO THE CERTIFICATE 14OLDER NAMED TO THECity of of .Santa Ana IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INS URElZ I TS AGF. NTS OR <br />20 Civic Center Plaza REPRESENT TTvea <br />Santa Ana CA 92701 AtmAo AnVE <br />ACORD 25 (2001108) ID ACORG CORPORATION 198 <br />