ASIAN AMERICAN SENIOR CITIZENS SERVICE -2012

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CERTIFICATE OF LIABICITY INSURANCE ACORD MIDDIY 2 DATE 2 . 05Z25/ Z01 05/2 1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NCONTACT AME: Krlsty Harrington Comprehensive Insurance Services - PHONE AlC.No,Ext) 949.709.8800 x230 _TaC No):949.709.1668 22342 Avenida Empress ADDRES?y@thecomprehensiveinsurance.com Suite 250 INSURER(S) AFFORDING COVERAGE NAIC p _ _ Rcho Sta Margarita, CA 92688 INSURERA: NONPROFITS' INSURANCE ALLIANCE INSURED Asian American Senior Citizens Service Center INSURERS 850 N. Birch INSURER C: Santa Ana, CA 92701 INSURERD: INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: GL REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR _ -- - POLICY LFF r POLICY EXP -- LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDD (MMIDIDffYYY) LIMITS GENERAL LIABILITY 2012-01391-NP 03/09/2012 03109/2013 E: rl _ LIFRG - F t 1,000,000 -- enPR I ?fvFRr ?BII_ITv ahE a '? on _o $ 500,000 Au I,l ;F X ,_cl;m. IFD F r IAn, n 20, 000 A ? X X PERSr I IA:_ n A INJUR r $ 1,000,000 SENERAL AGGREGATE 2,000,000 EI'i l , ,n[. TI MI J LIES PEP, 2,000,000 !X Li;C I Er f $ AUTOMOBILE LIABILITY 2012-01391-NP 03/0912012 03/09/2013 _ ;Ea ?oGi?en:i $ 1,000,000 -- ,I L 9UDIL'r IIVJl1F ! Poi :--.,ocl $ A ?F, -G EL,DIL I Ir JUF r acu I . ? X ,1 ED X - I rF I --- -- rti c- -T $ P t Y -- - i i uJ=n l i I $ UMBRELLA LAB C=U =?. H rUF .N_c $ _ EXCESS LIAB Cai F:E3_I,' 1CW ?I Y? WORKERS COMPENSATION eVC eTA I, _1 H- I AND EMPLOYERS' LIABILITY Y1 N ! `OFf LI'egITS R - --"----------1__--'--_-- ----------- --- - ,N'r F:IET F LTNEr E tr U?.liE :`FFI MEMLEr E -1 , I' F NIA I r c DEN- E (Mandatory in NH) =.L C i..L?.?G ` ENIRL E E ? II Ye J _nbe der -- -- - LE? I?l F'fJ'F =t Fv71_ r [?i_'ro E.L DISEHS-E L!-I LiklIT $ i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ERTIFICIATE HOLDER IS ADDITIONAL INSURED PER THE ATTACHED CG2026(07/04) ASTO"0' A??1kC ED ?. 141k TORCK 1 1. M I IFIV,M I I- nULVCrN L/11VLtLLH I IUIV . ni+v HlWI-1 / - SANTA ANA YOUTH COUNCIL WORKFORCE INVESTMENT BOARD 1000 E. SANTA ANA BLVD., SUITE 200 SANTA ANA, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-201 nhtc racarvarl ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD