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<br /> GOODIND-01 MART <br /> ~4CORG,„ CERTIFICATE OF LIABILITY INSURANCE DATE <br /> I 7/16/2010 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> D.L.D. Insurance Brokers, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Lic#OD25325 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 17712 Mitchell North ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Irvine, CA 92614 <br /> INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED Goodwill Industries of Orange County INSURERA: Philadelphia Insurance Companies <br /> 410 North Fairview INSURER B: <br /> Santa Ana, CA 92703- <br /> INSURER C: <br /> INSURER D: <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. 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 DD' POLICY EFFECTIVE POLICY EXPIRATION <br /> POLICY NUMBER LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 <br /> A X COMMF_RCIALGENF_RALLIABILITY PHPK593330 7/1/2010 711/2011 PREMISES Eaoccurence $ 300,000 <br /> CLAIMS MADE EKI OCCUR MED EXP (Any one person) $ 15.00 <br /> PERSONAL & ADV INJURY $ 1,000,00 <br /> GENERAL AGGREGATE $ 3,000,00 <br /> GEN-L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 3.000.00 <br /> POLICY PRO X LOC <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT $ <br /> ANY AUTO (Ea accident) <br /> ALLOWNEDAUTOS BODILY INJURY $ <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS <br /> BODILY INJURY $ <br /> NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO <br /> OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR CLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE <br /> RETENTION $ $ STAT_ WORKERS COMPENSATION AND W <br /> TOR CY 11.11-1 IT" ER <br /> EMPLOYERS' LIABILITY <br /> y ggyyy ' '`p ar8 E.L. EACH ACCIDENT $ <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE g <br /> OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ <br /> If yes, tlescribe under <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ <br /> OTHER J ORCK <br /> LISA E. S <br /> Assistant Cit Attorney <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SP IAL PROVISIONS <br /> SeB attached page. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> The City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN <br /> 20 Civic Center Plaza <br /> M-76 - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> Santa Ana, CA 92701- IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE <br /> ACORD 25 (2001/08) O ACORD CORPORATION 1988 <br /> EXHIBIT C <br />