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.Jue•25. 2004_ 2:07PM— I: '-_ <br />FtCURDN CERTIFICATE uF LIABILITY INSURANCL <br />OATS MMNJ: r ; -y <br />PRODUCER Schweickert tic Company <br />3090 Bristol Street <br />Suite 160 <br />Costa Mesa CA 92626 <br />INSURED Mercy House <br />P.O. Box 1905 <br />Santa Ana CA 92702 <br />THIS CERTIFICATE IS ISSUED AS A MAT <br />ONLY AND CONFERS NO RIGHTS UP( <br />HOLDER. THIS CERTIFICATE DOES NOT <br />OF INFORMATION <br />'HE CERTIFICATF <br />END, EXTEND OR <br />INSURERS AFFORDING COVERAGE _ NAIL <br />INSURER A: Great American IM%LranCC Company <br />INSURER 8: — <br />RlSURE I U: _... <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED- NOTWP H1 aNNN( <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE '.S£ JEr 7F <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONc TrF <br />POLICIES. AGGREGATE LIMBS SHOWN MAY HAVF RFFM DFIII ICPh vV ..,n.. Anrc <br />INSR <br />_._-.., <br />UCY NUMBER <br />POMCY EFFECTiYE <br />05l02/2004 <br />PO4JCY EXPIRAITON <br />05/02/2005 <br />LIMITS <br />-- <br />y__ <br />GENERAL <br />LIABILITY <br />PAC5373885 <br />EACH Occumt:NCE <br />A <br />X <br />X <br />COMMEHCwt GENERAL LIABILRY <br />Sa Abuse Aggregate limit is <br />DAMAGE TO RENTED __ _ <br />_ j()(101)I <br />F <br />CLAMS MADE. OCCUR <br />SI,(lili),OBU <br />MED UP(AnYonc <br />X <br />Professional Liability <br />NA a Nov INuuR <br />Nu deductible or$IR <br />)00.001 <br />- <br />X Abuse& Molestation <br />- -- <br />GENERAL AGGREGATE <br />„.)0. <br />S _ 0,pUi <br />CEML AGGREGATE LIMIT APPLIES PER: <br />j� <br />- <br />PRODUCTS-COMPiOP AGG <br />j 5 - '100,001 <br />X POLICY <br />AUTOMOBILE <br />LIABROY <br />PAC5373885 <br />05/02/2004 <br />05/02/2005 <br />ANY <br />COMBINEDSINGLE LIMIT S illl)(il11 <br />_ <br />AUTO <br />(U .�cddrntl <br />ALLOWNEDAUTOS <br />BODILY INJURY ,S <br />SCHEIXILEO AUTOS <br />(P a Po n) <br />AL <br />X <br />X <br />HIRED AUTOS <br />X <br />A, <br />X <br />BODILY INJURY S <br />NON-OMEDAUT05 <br />(PWacclo,,,D <br />PROPERTY DAMAGE <br />- <br />(Per acaeenQ <br />GARAGE LIABILITY <br />AUTOONLY LA AOGIOFFT I <br />.. <br />- <br />j <br />ANYAUIO <br />OTHER THAN Acc <br />ALTO OWY: AGG <br />S _ <br />E%CiMUUMBRELLA LIABILITY <br />EACH OCCURRENCE <br />OCCURCtAIMS MADE <br />AGGRCGATE $ <br />DEDUCTIBLE <br />ftETENMN <br />WORXEU COMPENS"IDNAND <br />I WCSTAT LOTH- <br />EMPLOYERS' LIABILITY <br />._ _.. <br />ORY LIMITS _ rsLt—, <br />E.L. <br />E.L. EACH ACCOEM <br />OMTE <br />_ ---' <br />II ., testribe wrin <br />EL DISEASE , G GMPLOYF. F, S <br />E .JAI VIA <br />OMER <br />;�^ �^..�,..........«„miner LAA�ATIDN9f YETTICLElIE%CLUSIONS ADDED BY FIIDpRSEMENTI SPECML PROVISIONS <br />(he City of Santa Ana, its officials, employees,.representatives, and vohmteers are hereby named as Additional Insureds as <br />cSpects the operations of or on behalf on Mercy House Transitional Living Center, performed under contract with The City of <br />Tanta Ana- <br />:ERTIFICATE HOLDER <br />City of Sawa Ana <br />20 Civic Center Plmt <br />PO Bux 1988 <br />Santa Am CA 92702 <br />� ✓l t1L:.r 1, I: .:� <br />,CORD 25 (2001/081 <br />SHOULD ANY Of THE ABOVE DESCRIBED POLICIES ENE CANCELLED SEFOR THE F_xcIRATIOF <br />DATE THEREOF, THE ISSUING INSURER WILD-'" ApOWTO MAIL oAll WRITTEN <br />NDneE TOME CERnPTCATE HOLDER NAMED TO THE LEF rWTYABORL TLTDU'. VALI <br />rMPOSEli6TT8LiGArmrraRiaAennrrrF iV1YRIlaD TIPOTTTTEINSnRE� MY xf.ET:Ts 3F <br />AUMORIMD REPRESENTATIVE <br />(0 ACORD CORPORATION 1989 <br />