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<br />
<br />9497562713
<br />
<br />P02/0! F-547
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<br />1 Of6/05
<br />
<br />PROD\.lCeR
<br />Driver. AJlianllnsurance Services. Inc,
<br />P,O, Sox 25884
<br />Santa Ana, CA 92799
<br />(BOO) 821-9283 Ex!. 190 . Fax (949) 706-2713
<br />Lieen&8 No. ~1
<br />lNSURiO SPEClAL LlAI5LlfY lN$iJAANCE PROGAM4 ~LtPj W;;MIifR---
<br />FAMII.IES TOGETHER OF ORANGE COUNTY ,4--';;;004 _ ;;;;"'0 I
<br />801 S, I. YON ST.
<br />SANTA ANA. CA 92705 k ,:}Ct:Y'/ - ..10;;J..
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<br />THIS CERTIFICATE.S ISSUED AS A MATTER OF INFORMATION ONLY AND
<br />CONFERS NO RIGHTS UPON THE CERllACATE HOLDER. THIS CERllACATE
<br />DOES NOT AMEND, EXTEND OR ALTER rHE COVERAGE AFFORDED BY THE
<br />POUCIES BELOw,
<br />
<br />COMPANIES AFFORDING COVERAGE
<br />
<br />COMPANY
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<br />COI!PAl/'i
<br />U!TTER
<br />MY
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<br />LETTI!R
<br />COIIIPANY
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<br />A EVANSTON INSURANCE COMPANY
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<br />THW IS TO CERTIf!V TKA.T TH! POUCIQ: OF INSUWoIcI! LIIT&O IELOW HAVI!! BEDI THe INSUREQ ~g ~ ,.OFt- THI.!"CILlCY KRIOP INOICATED.
<br />NO'TWrrHSTANOt~ IV('( AEOUIREMIlNT, TliRM 0fII CONDITION OF AHfCMMCT OR 0lltER QOCuMOiT W1T"Re~mr TO WHICH 'Oft. CIUtTlPtCATE IW4V AlISSUf;D
<br />OR MA,l' PERT""'. THE .NSIJR.\NCI AfFORDep IIW TtIlI fi'Ouae oeac..lttl1lftE1N III SUBJI!CT TO AU. THE TER. JiXCl.uStON AND COWDIT1ONS OF SUCH PO..IC:~
<br />UMfTS a MAY HAVE Bl!lEN ftl!OUeED BY P.AID CLAIMI.
<br />
<br />
<br />CO
<br />LTR
<br />
<br />
<br />GENERAL I..IA8ILJTY
<br />COMM!ACI/U. GENERAL
<br />LIABILITY
<br />CI.AIMS f)(l OCCUR
<br />MACE ~
<br />OWNER'S" CON'rRACrMs
<br />PROT.
<br />GL OED.S1,OOO
<br />
<br />SI.IP300(}.OS
<br />
<br />09129105
<br />
<br />!'<lUCY
<br />EXPI~noN
<br />"'IT" M
<br />09129/06
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<br />laTa
<br />
<br />TYPE OF 'N8UIIANc.
<br />
<br />POUCV MJl48SA:
<br />
<br />POLICY .ffKTM'-
<br />DATI. {Ut.lteovvJ
<br />
<br />A
<br />
<br />allNBlALAGGReGATE
<br />PROOUCTS-COMPIOf'
<br />AGG,
<br />PER$ONAl $. AO'l/. INJl.RY
<br />
<br />EACH OCCUfA!HCE
<br />
<br />NlA
<br />$1,000,000
<br />$1,000.000
<br />$1.000,000
<br />$1.000.000
<br />NfA
<br />$1,000,000
<br />
<br />A
<br />
<br />AlITOMOIlILE I.IAllIUTY
<br />
<br />SUP3OO~05
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<br />09
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<br />09129f06
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<br />ANY AUTO
<br />AlJ. OWNED AUTOS
<br />SCHEOul.EO AUTOS
<br />X JoIIFU;O ",u-rOs
<br />X IIK>k-OWNeO AUTOS
<br />GARAGE UAAJI..ITY
<br />AUTO oeD: $1,000
<br />
<br />UMBRELlA FORM
<br />OTH~ T~ UMBI'tELlA FORM
<br />
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<br />OODlLVjNJU~
<br />(~r~..onl
<br />8OOl'lJNJl,IR'r'
<br />(P~ 0101:1"'1)
<br />PROPERTY OAMAGE
<br />
<br />APPROVED AS 0 FORM
<br />
<br />.E^01 OCCvAAENCE
<br />AGGREGAT~
<br />
<br />WORKER's COMPBlSA'nON
<br />AHP
<br />EMPI.OYiER"& LIABILITY
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<br />EACH ACCtPQ(T
<br />DlSEASI;.POllCv LIUrT
<br />OI&EASE-EACH EM i- e
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<br />A
<br />
<br />NON-PROFrT DIRECTORS
<br />AND OFFICERS
<br />
<br />SI.IP3000.05
<br />
<br />09129105
<br />
<br />09129106
<br />
<br />$1.000.000
<br />
<br />PER OCCURRENCe AND
<br />ANNUALAGGfleGATE
<br />
<br />PQ~ION OF OPERATlONSJI.OCA.."ON5o'VEHCLUIS~1Al. n1:MS
<br />
<br />AS RESPECTS TO THE COMMUNITY DEvELOPMENT BI.OCK GAANT, THE CITY OF SANTA ANA. ITS OFFICERS. AGENTS. EMPLOYEES AND
<br />VOLUNTEERS SHAI.L BE ~MED AS ACOITIONAL INSURED. THIS INSURANCE IS PRIMARY ANO ANY I"'SuRANC~ OR SELF INSURANCe MAINl AINED BY
<br />SUCH ADDITIONAL INSUReDS SHAll NOT CONTRIBUTE TO IT. ADDlTION.A/.. INSURED ENDORSEMENT A TTACHEO, SUBJECT TO POl.ICY TERMS,
<br />CONDITIONS AND ExCLUSIONS.
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<br />CITY OF SilNT A ANA
<br />COMMUN'TY DEVElOP"'~N'T AGENCY M-25
<br />20 CIVIC CENTER DRive
<br />PO BOX 1_
<br />SANTA ANA,CA 92702
<br />
<br />SHOUI-D <\Ny 01' TIlE ABO\l~ DESCRiBeD POUClES BE CANCEI.l.EC BEFORE rHe
<br />EXPIRATION DA'tIiTHEREOF. THE I$SUING COMPANY W\I..L ~W',!::'H''''''Cf"fa MAlL
<br />"SO PAYS WRITTEN NOTICe TO THE CERllFICATti HllI.OER NAMED TO THE LeFT.
<br />BUT FAILURe TO MAlL :;JUCH NOTtCE SttAl.L IMPOSE NO OBLIGATION OR L..tAalulY
<br />Of ANY KIND UPON 'tHE COMPANY. ITS AGlitHS OR REPRGSlSNTATIVES
<br />"EXCEPT 10 OAY$ FOR NON-PAYMl:NT
<br />AU ORIZEO A TIV
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