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ACORE CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br />TM 08/02/2012 <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 CONTACT <br />NAME: <br />Comprehensive Insurance Services PHONE 849.709.8800 FAX <br />_(LN No E4t . _ WC, No): 949.709.1668 <br />22342 Avenida Empresa E-MAIL <br /> ADDRESS: <br />Sul to 250 INSURER(S) AFFORDING COVERAGE NAIC # <br />Rcho Sta Margarita, CA 92688 INSURERA: Travelers Property & Casualty <br />_ <br />INSURED Mental Health Association of Orange County INSURER B: <br />822 Town & Country Rd. INSURERC: <br />Orange, CA 92668 INSURER D : <br /> INSURER E : <br /> INSURER F <br />COVERAGES CERTIFICATE NUMBER: WC REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED -1 O THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 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 <br />LTR <br />TYPE OF INSURANCE <br />INSR <br />WVD <br />POLICY NUMBER P LICY EFF <br />MM/DD/YYYY P LI Y EXP <br />MM/DDNYYY <br />LIMITS <br /> GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br /> COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ <br /> CLAIMS-MADE OCCUR MED EXP (Any one person) $ <br /> PERSONAL & ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ <br /> POLICY PRO JECT LOC $ <br /> AUT OMOBILE LIABILITY COMBINED SINGLnI IT <br /> (Ea accident) $ <br /> ANY AUTO BODILY INJURY (Per person) $ <br /> ALL OWNED <br />AUTOS SCHEDULED <br />AUTOS BODILY INJURY Per accident) $ <br /> <br />HIRED AUTOS NON-OWNED <br />AUTOS ERTY DAMA <br /> <br />(Per accident) $ <br /> <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> <br /> DED RETENTION $ $ <br /> WORKERS COMPENSATION <br />' UB3524T36112 08/01/2012 08/01/2013 OTH- <br />X WCS <br /> AND EMPLOYERS <br />LIABILITY Y / N LIMT <br />TORY LIMITS _ __L_ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIV E <br />L <br />EACH ACCIDENT $ 1 000 000 <br />A OFFICER/MEMBER EXCLUDED? N / A . <br />. > > <br /> (Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />1 <br />000 <br />000 <br /> , <br />, <br />_ <br />- - <br /> DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 <br /> <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />CER I (FICA I t HOLDER CANCFI I ATInN <br />CITY OF SANTA ANA, ITS <br />EMPLOYEES <br />ATTN: FRANK HERNANDEZ <br />20 CIVIC CENTER PLAZA, <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 />OFFICERS, AGENTS AND ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />M-25 ?GZ <br />Richard Evnon_ CIC/7FRFMY <br />1988-2010 ACORD CORPORATION_ All rinhfs rosorvurt <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD