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ASSISTANCE LEAGUE OF SANTA ANA - 2004
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ASSISTANCE LEAGUE OF SANTA ANA - 2004
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Entry Properties
Last modified
10/13/2015 3:28:09 PM
Creation date
11/20/2004 1:31:56 PM
Metadata
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Template:
Contracts
Company Name
Assistance League of Santa Ana
Contract #
A-2004-087-03
Agency
Community Development
Council Approval Date
5/3/2004
Expiration Date
6/30/2005
Insurance Exp Date
6/1/2006
Destruction Year
2010
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A00-RD CERTIFICATE OF LIABILITY INSURANCE <br />oaio9Mizoo ) <br />PRODUCER (949) 709 -8800 FAX (949)709 -1668 <br />Comprehensive Insurance Services <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />22342 Avenida Empresa <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />Suite 200 <br />RSM, CA 92688 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED Assistance League of Santa Ana <br />INSURERA: NONPROFITS' INSURANCE ALLIANCE <br />GENERAL LIABILITY <br />1037 W. First Street A- , ?oo,1- o'v_ D3 <br />INSURERS <br />06/01/2006 <br />Santa Ana, CA 92703 A , <br />INSURER C. <br />DAMAGE TO RENTED <br />eI, SFC (Earc <br />i <br />f't <br />INSURER D: <br />INSURER E: <br />I+VYCnMV V <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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 <br />DD' <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />&A")k4+14X1%"-t(+`€%Ugd Wi%.sl(NrXl6iCSVdk *Y&)'.X")O MkXXXXXXXXX <br />AUTHORIZED REPRESENTATIVE i <br />SANTA ANA, CA 92702 <br />GENERAL LIABILITY <br />2005- 07 504 -NPO <br />06/01/2005 <br />06/01/2006 <br />EACHOCCURRENCE <br />$ 1,000,00 <br />DAMAGE TO RENTED <br />eI, SFC (Earc <br />X COMMERCIAIGENERAL LIABILITY <br />$ EIDO <br />CLAIMS MADE O OCCUR <br />MEO EXP (Any one person)_ <br />$ 10,000 <br />A <br />PERSONAL 8 ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 3,000,00 <br />GEN-L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS- COMP /OP AGG <br />$ 3,000,000 <br />POLICY ZMl X LOC <br />AUTOMOBILE <br />LIABILITY <br />2005- 07 504 -NPO <br />06/01/2005 <br />06/01/2006 <br />COMBINED SINGLE LIMIT <br />$ <br />ANY AUTO <br />(Ea awd.r,t) <br />1 - QQQ , QQ <br />X <br />ALL OWNED AUTOS <br />BODILY INJURY <br />$ <br />(Per person) <br />A <br />SCHEDULED AUTO$ <br />HIRED AUTO$ <br />BODILY INJURY <br />$ <br />NON -OWNED AUTOS <br />(PM acdberti) <br />_ <br />— <br />PROPERTY DAMAGE <br />$ <br />— <br />(Per awieeol) <br />GARAGE <br />LIABILITY <br />AlfTO ONLY_EA ACCIDENT <br />$ <br />ANY AUTO <br />OTHER THAN EAACC <br />$ <br />AUTO ONLY AGG <br />$ <br />EXCESS(UMBRELLA LABILITY <br />2005- 07 504- UMB -NPO <br />06/01/2005 <br />06/01/2006 <br />EACHOCCURRENCE <br />S 3,000,00 <br />AGGREGATE-__ <br />�AIMS MADE <br />OCCUR C <br />$ 3,000,00 <br />A <br />- -- <br />$ -- <br />X1 DEDUCTIBLE <br />$ <br />X RETENTION $ <br />$ <br />WORMERS COMPENSATION AND <br />2005 - 07504 -DO <br />O6 /01A /2005 <br />06/0172006 <br />WC STATU- OTIi <br />EMPLOYERS' LIABILITY <br />APPRO <br />EL) 5 l( <br />A <br />H') <br />EL E.L. EACHACCIDENT <br />$ 1.000,GOO <br />A <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />OFFICERWEMBER EXCLUDED? <br />E.L. DISEASE - EA EMPLOYE <br />$ 11000,000 <br />If yes, deSr . ender <br />SPECIAL PROVISIONS eebw <br />{ - <br />": �� <br />E1 DISEASE - POLICY LIMIT <br />$ <br />OTHER <br />.'tItt SCa' <br />-ly <br />Assi <br />tent City Att4...1. <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSION$ ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />E: FUNDING <br />10 DAY NOTICE SHOULD THE POLICY CANCEL FOR NON- PAYMENT <br />ERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED PER THE ATTACHED CG2026 (07/04) <br />CERTIFICATEHOL ER CANCELLATION <br />ACORD 25 (2001108) FAX (714)647 -6580 ©ACORD CORPORATION 1988 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL 04"XJEX hMAIL <br />CITY OF SANTA ANA <br />*30 DAYS WRITTEN NOTICE TOTHE CERTIFICATE HOLDER NAMED TO THE LEFT <br />COMMUNITY DEVELOPEMENT AGENCY <br />INIXr)€ XSIYrbMXXiCXi( MY+ X9ftEltS$ YdUfNdk763F #1bYd�X�kX.D(dW�iXi�A�104XXX. <br />M -25 <br />P.O. BOX 1988 <br />&A")k4+14X1%"-t(+`€%Ugd Wi%.sl(NrXl6iCSVdk *Y&)'.X")O MkXXXXXXXXX <br />AUTHORIZED REPRESENTATIVE i <br />SANTA ANA, CA 92702 <br />Richard E non, CIC /KRISTY <br />ACORD 25 (2001108) FAX (714)647 -6580 ©ACORD CORPORATION 1988 <br />
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