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<br />,i-'--------'" I DATE IMMIOD/YYYYl <br />ACOBIJ.. CERTIFICATE OF LIABILITY INSURANCE 12/28/2004 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />SST INSURANCE 8ROKERS INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />PO 80X 1489 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />SONOMA, CA 954761489 <br />1888) 661-3938 <br />SV675 882 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED INSURER A:TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA <br />NEW WAYS TO WORK, INC, <br />SAN FRANCISCO INSURER B: <br />103 MORRIS STREET INSURER C: <br />SEBASTOPOL, CA 95472 INSURER 0: <br /> INSURER E: <br /> <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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE 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 />~~~R ~~~'; POLICY EFFECTIVE POLICY EXPIRATION <br /> TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDIYYl DATE (MM/OO!YYI LIMITS <br />A ~NERAL L1ABIITY 660-B40C2240-04 10/01/2004 10/01/2005 EACH OCCURRENCE $1000000 <br /> ~ 3~MERCIAL GENERAL LIABILITY DAMAGE TO RENTED .100,000 <br /> ~ CLAIMS MADE 00 OCCUR MEDEXPlAn one nersonl $5000 <br /> PERSONAL & ADV INJURY $1.000,000 <br /> ....."NERA' ;RFr.ATE $1000,000 <br /> ~'L AGGREGATE LIMIT AnES PER: PRODUCT" - COMPlnp AGr. $1,000,000 <br /> n:RO- <br /> X POLICY JECT LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> - lEa accident) $ $1 ,000,000 <br /> - ANY AUTO <br /> - ALL OWNED AUTOS BODILY INJURY $ <br /> {Per person) <br /> - SCHEDULED AUTOS <br /> ~ HIRED AUTOS BODILY INJURY <br /> ~ {Per accidentl $ <br /> NON-OWNED AUTOS <br /> PROPERTY DAMAGE . <br /> (Peraccidenti <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> R ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG . <br /> 3CESS/UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR 0 CLAIMS MADE AGGREGATE $ <br /> . <br /> =1 DEDUCTIBLE . <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND I .rc;~tI~Ns I I Ol~ <br /> EMPLOYERS' LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ^t'~1tOVtlO A- TO tlQlUv E.L. EACH ACCIDENT . <br /> OFFICER/MEMBER EXCLUDED? E.L. OlSEASE- EA EMPLOYE'E $ <br /> If yes, describe under - E.L. DISEASE - POLICY LIMIT $ <br /> SPECIAL PROVISIONS belOW <br /> OTHER 'f.')/'<. ,-;;;;(.{ <br /> Laura Sl1tt Sheedy <br /> Assistant Cit, IAHM' , <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />OFFICE <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />COVERAGES <br /> <br />CITY OF SANTA ANA <br />WORK FORCE INVESTMENT BOARD <br />A TTN: FRANCES <br />888 W, SANTA ANA BLVD.. STE. 209 <br />SANTA ANA, CA 92701 <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br /> <br />YII~ <br /> <br />ACORD 25 (2001'08) <br /> <br />@ACORD CORPORATION 1988 <br />