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<br />Feb-24-05 02:07P Mar1a Halverson
<br />
<br />P.02
<br />
<br />
<br />PRODUCER
<br />Driver. AUiant Infliuranco Serviens, Inc.
<br />P.O. 80. 25684
<br />Santa Ana, CA 92799
<br />(800) 821.9283 ElCt 190. Fox (949) 756-2713
<br />l.Jc.n~ No. OC36&61
<br />INsURED 'SPCCi;.[i>>.iiLlNlHSulWCE.. lSLl~""'IA~H'
<br />FAMILIES TOGErHER OF ORANCE COUNTY
<br />80' S, l YON ST,
<br />SANr A ANA. CA il270S
<br />
<br />tS~t-L1Aft:IMM"'OOl'n',
<br />2/14/05
<br />
<br />
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF lNFOIlMATIONON/,.V JINO.,.'.
<br />CONFIRS NO RIGHTS UPON rHE CEllnFlCATE 1l0LDER. THIS CElmFfC.Ii'rE' '
<br />DOIS NOT AMEND, EXTEND OR ALTER THE coveltAGl! AfFO_D 8YTHE
<br />POUCIES 8ELOW,
<br />
<br />COMPANIES AFFORDING COVERAGE
<br />C~OWM\; no. .".-----~._- ___..._......, ,... ____
<br />lO"'" A ILLINOIS UNION INSURANCE C()MF>ANY
<br />_.'~___~.M. .'..,-__....._____
<br />COIlIPAHY B
<br />LETTI!Il
<br />." C'O,..ANY
<br />LETTI!Il C
<br />..C"OWA..".,-------
<br />Lan.1lI D
<br />COMPANY E
<br />L!nl!ll
<br />
<br />.-......-...-...
<br />
<br />~ \. .: .
<br />THIS. TO C&1tT1~ THAT THl POL.It:IU OJ: INIURAHCa Ul'l'1IO"lOW HAW( .lI!eN IHUED TO TI-I!! IUltll'tED NAMED AacYl FOR' ,NIl. "OUCy "'1aOO IN/)ICATED.
<br />NO'TWITHSTl\NDfNQ. All., IIEOUMM&HT. TaAM OR CONDI1lOH ot= ANY COHTaA(;t O..1'J'rttM DOCUII!!:NT MTl1l11t8P!CT TO WNCH T.. CERT~TI_,... tStufD
<br />OR 'My NRTNN, THE JHSUMIfCI! Al"fORD!D BY THE POUCIf.S DElCRIBIIID IWlEJN IS. SL*.IECT TO AU. THE lE_. !XCLUSION MO CONDlTlClNI ClF ~ POt.IeIe6,
<br />~....,.. MAY HAft REM ReDUCED BY PAID CLNIlIIJ.
<br />----,.-------,.-----'''....n . ".'~__h.__._ _______.______
<br />CO
<br />LTR f't,.. Of" Jft$URANCE
<br />
<br />A
<br />
<br />
<br />GENERAL LIlUIJTY
<br />COMMeftCIAl. Gl:NEnAl
<br />llMlUTV
<br />~ 0 OCCUR
<br />OWNER'S I CONTRACTOR'S
<br />Pf<<(f(. .._______...._.__
<br />GLDED:$l,aoo
<br />
<br />G22078456
<br />
<br />10/27104
<br />
<br />-"pOiiCf -,'~,..
<br />DPIIlATIOI't
<br />DATE MMIDtPYV
<br />09129/05
<br />
<br />LIOT.
<br />
<br />roUCY NUIIlftll
<br />
<br />POLICY EFFiCTIVE
<br />DATElMlWDOIVV)
<br />
<br />G22078456
<br />
<br />1 /
<br />
<br />09/29/05
<br />
<br />
<br />GENEItAL AOQRIGATE
<br />rAODuCTS-COMPIOP
<br />
<br />rERSONAL & N:N. INJURY
<br />
<br />"su.lOYtr .
<br />
<br />A
<br />
<br />AUTOMOtJIL! UABR./TY
<br />.\Nl'Al)TO
<br />All OWl\lF{lA~rIO~
<br />SCHHNJI.F.OAUros
<br />X HIReD AUTOS
<br />! X NON.QWNED AUTOS
<br />GARAGti LIAS/UTV
<br />AUTO OED: $1,000
<br />
<br />EACH OCCURRENCE
<br />
<br />FIRIi OAMI\G&: CAPI)';;;r;;r
<br />Mf:1). 1!Xf'E::::1tSE (Anyone
<br />
<br />$' .000,000
<br />$1,000.000 .
<br />..,-~
<br />$1.000.000 .
<br />S1.000.~._
<br />N/A
<br />$ 1 ,000,000;
<br />
<br />APPROVE' AS
<br />
<br />, 'ReiOli7'iN.lU
<br />(~Jf'Ir.rnn"1
<br />BODilY INJU""
<br />(Per 100(111'1)
<br />PftOpe~ DAW.GE
<br />
<br />UWBl1ClLA rOAM
<br />on.f1iR n~"", UMBRFL lA FORIwI
<br />
<br />
<br />F.-ACU OC(',.I:JRR , E
<br />
<br />:;.-'5/
<br />
<br />
<br />WO'UCIW'COllllllltN$ATION
<br />AND
<br />IMPL.OYlR'.~
<br />
<br />AHorne\
<br />
<br />A
<br />
<br />NON-PROFIT DIRECTORS
<br />AND OFFICERS
<br />
<br />G22078458
<br />
<br />10/27104
<br />
<br />09/29/05
<br />
<br />$1,000,000
<br />
<br />PI!R OCCURREN~ AND
<br />ANNUAt.AGGREGl.TE
<br />
<br />OEICRI N '" IT
<br />. ~TE (:,.........ILilll:ifll,~I........ "'...... """'~""lil,ob~itJ:. i., u...~)Ii"'WI""'" ~Ql....,
<br />
<br />AS RESF>ECTS TO rHE COMMUNITY OEVElOF>MENT BlOCK GRANT, THE CITY OF SANTA ANA, ITS OFFICERS, AGENTS I\NO EMPLOY~~S SHAU BE
<br />NAMED AS ADDITIONAL INSURED. AD[ljTIONAL INSURED ENDORSEMENT ATTACHED. SUIlJECT TO FOLlCY TERMS, CONDITIONS AND EXCLUSIONS,
<br />
<br />.
<br />
<br />
<br />SHOULD ANY OF THIi ABOVE DE8CRlBliD F>OLJCIES BE CANCIiLLIiD BEFOIlE THE
<br />.!XJlaUTI01II OAre THEIlliEOF~ THE ISSUING COM~ANYWlLL ..I"'~"'~- ." MAIL
<br />:a DAYS WRITTEN NOnCE TO THE CERnFICA TE HOLDER NAMED ro THE LEFT.
<br />aUT FAILURE TO MAJI,. SUCM NOTICI! SHALL IMPOSE NO OIIUGATION ORLlAB.....TY
<br />01 ANY KINO UPON THE COMPANY. ITS "GENTS OR REI'RESENTATlVES
<br />'EXCEI'T to DAYS FORNON-PAYMENT
<br />A
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<br />
<br />CITY OF SANTA ANA
<br />20 CIVIC CENTER PLAZA. M-25
<br />SANTA ANA,CA 92702
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