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