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1-1 +wlxw. IC VI' LIHCILII T INJUKHNI.t 1 09/23/2008 <br />PRODUCER (94WO9-8800 FAX (949) 709-1668 <br />Comprehensive Insurance Services <br />22342 Avenida Empresa <br />Suite 200 <br />RSM, CA 92688 <br />THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION <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 BELOW. <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURED <br />Latino Youth Leadership Institute <br />2321 E. 4th St. Ste. C-428 <br />Santa Ana, Ca 92705 <br />INSURERA NONPROFITS' INSURANCE ALLIANCE <br />INSURER B. <br />INSURER C: <br />INSURER D: <br />INSURER E. <br />VW 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 <br />JjJLlNSR <br />ADD -L <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />Ki(ADFX*)V(MKX)OMXVAXXXMKXNKKK%X tl4XWA*XXXXXXXXXX <br />AUTHORIZED REPRESENTATIVE 7 <br />GENERAL LIABILITY <br />2008 -13325 -NPO <br />08/05/2008 <br />08/05/2009 <br />EACH OCCURRENCE $ 1,000,00 <br />X COMMERCIAL GENERALLIABILITY <br />DAMAGE TO RENTED S 100 QQ <br />CLAIMS MADE FxI OCCUR <br />MED EXP (Any one perwn) $ 10,000 <br />A <br />PERSONAL B ADV INJURY $ 1,000,000 <br />GENERAL AGGREGATE $ 1,000,00 <br />GEHL AGGREGATE UNIT APPLIES PER <br />PRODUCTS - COMPIOP AGG $ 1,000,00 <br />NLICV PROJECT X LOC <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMB $ <br />ANY AUTO <br />(Ea accident) <br />BODILY INJURY S <br />PLL OWNED AUTOS <br />SCHEDULED AUTOS <br />(Per parson) <br />BODILY INJURY $ <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />(Per acOderg <br />PROPERTY DAMAGE $ <br />(Per accidenl) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EA ACC $ <br />ANY AUTO <br />' <br />• ° .. .. <br />'�'I �:' F.,r i <br />AUTO ONLY AGO $ <br />EXCESSNMBRELLA LIABILITY <br />EACH OCCURRENCE S <br />OCCUR CLAIMS MADE <br />AGGREGATE $ <br />$ <br />DEDUCTIBLE <br />RETENTION $ <br />i4Y <br />i'ii i�.'�' ;�. <br />8 <br />WORKERS COMPENSATIONAND <br />WCffiATU- OTH- <br />IMITS ER <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNER/EXECUTIVE <br />EL EACH ACCIDENT $ <br />E . DISEASE - EA EMPLOYE S <br />OFRCERIMEMBER EXCLUDED' <br />IT yes dunder <br />SPECIAL MPROOVISIONS below <br />E . DISEASE - POLICY LIMIT $ <br />OTHER <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS <br />ERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED PER ATTACHED ENDORSEMENT #CG2026 <br />EXCEPT 10 DAYS FOR NON-PAYMENT <br />RIMARY WORDING APPLIES PER POLICY FORM ATTACHED <br />CFRTIFICATF NO] DFR CANCELLATION <br />ACORD 25 (2001108) ©ACORD CORPORATION 1988 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREIiOF, THE ISSUING INSURER WILL �MXXM MAIL <br />CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES <br />A30 <br />AGENTS AND VOLUNTEERS <br />DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />CDBG M-25 <br />KOmFXKIODXK*X)k1414Yi1d67Dd81fx7UWMK)GXKDF7Nf16M76XXIXD(1MXX <br />P.O. BOX 1988 <br />Ki(ADFX*)V(MKX)OMXVAXXXMKXNKKK%X tl4XWA*XXXXXXXXXX <br />AUTHORIZED REPRESENTATIVE 7 <br />SANTA ANA, CA 92702 <br />Richard E non, CIC 7EREMY ,4�*•k.<�'•^- <br />ACORD 25 (2001108) ©ACORD CORPORATION 1988 <br />