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<br />A` ?'QRO® <br />CERTIFICATE OF LIABILITY INSURANCE DATE (MMMDNYM <br />3/28/2012 <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 AMTAC T Marlene. valencia <br />Brown & Brown Insurance Services of CA, Inc. PHONE (714) 221-1800 FAX (734) 221-419& <br />KtI: <br />. <br />9 <br />500 N. State College Blvd. mvalencla@bbsocal.com <br />!M <br />1 <br />Suite 400 INSURERS AFFORDING COVERAGE. NAIC#.. <br />Orange CA 92868 INSURER A.-Companion Property and Casualty 12157 <br />INSURED INSURER 8 <br />Women's Transitional Living Center INSURERC: <br />PO Box 6103 INSURER D : <br /> INSURER E : <br /> <br />Orange CA 92863 <br />INSURERF: 0 dd <br />COVERAGES CERTIFICATE NUMBER:2012-2013 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 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 ADDL SUBR <br />POLICY NUMBER POLICY EFF <br />M ! DIYYYY PO C <br />DY.EXP <br />LIMITS. <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY <br /> <br /> <br />- <br />DAMAGE TO RENTEff- <br />PR <br />EMISES occurrence) <br /> <br />$ <br /> CLAIMS-MADE r <br />] OCCUR MED EXP An one person) $ <br /> PERSONAL & ADV' INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ <br /> POLICY PRO- LOC $ <br /> AUT OMOBILE LIABILITY OMaIN D SINGLE LIMIT <br />E a "eide <br /> ANY AUTO BODILY INJURY (Per person) $ <br /> ALL OWNED <br />AUTOS SCHEDULED <br />AUTOS BODILY INJURY (Per accident) $ <br /> HIRED AUTOS NON-0VuNEO <br />AUTOS PROPERTY DAMAGE <br /> <br />' <br />socidentl $ <br /> <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> <br />EXCESS LIAB <br />CLAIMS-MADE <br />AGGREGATE _ <br />$. <br /> DED RETENTION $ $. <br />A WORKERS COMPENSATION <br />AND EMPLOYERS UA131UTY STATU- <br />X <br />'I.I. <br /> Y / N <br />ANY PROPRJETOR/PARTNER/EXECUTIVEF-I <br />IA . <br />E.L. EACH ACCIDENT $ 1 000 000 <br /> OFFICERJMEMBER EXCLUDED? <br />(Mandatory In NH) N PCA15007 /28/2012 /28/2013 E.L. DISEASE - EA EMPLOYE $ 11000,000 <br /> 1, <br /> <br />yyoSCRs desIPTcrIONa Ounder <br />DE <br />F OPERATIONS below <br /> <br /> <br />.L. DISEASE -.POLICY LIMIT <br /> <br /> <br />1 0.00 .000 <br /> <br />DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) <br />City of Santa Ana - CDBG M-25 <br />ESG <br />Attn: Frank Hernandez <br />P.O. Box 1988-M-25 <br />Santa Ana, CA 92702 <br />ACORD 25 (2010/05) <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 />Scott Murphy/IAVALEN <br />®1988-2010 ACORD CORPORATION. All rights reserved. <br />INS025 (2oloos).o1 The ACORD name and logo are registered marks of ACORD