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<br />
<br />PRODuCER
<br />Driver + Allianllnsurance Services, InG.
<br />PO, Sox 25884
<br />Santa Ana. CA 92799
<br />(800) 821-9283 Ex!. 190. Fax (949) 766.2713
<br />Lieen&8 No. 0C368tl1
<br />'"SUMO SPECIAl LWtl.Jtv 1N$I"lRA.NCE PROGAAI.4 ($LIPJ W;;t4ER~ .
<br />FAMII.IES TOGETHER OF ORANGE COUNlY ;4-.:;/o,yl-;;W I
<br />801 S, I.YON ST.
<br />SANTA ANA, CA e270~ ~ ~ - ..2o~
<br />A- ;;wu'f-;)..rJ( - 01
<br />Ao-a-004-a.t);l.- 01
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<br />/l-0Ec3' -07,1'-0/-1-
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<br />T-470
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<br />P,02/03 F-547
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<br />10/6/05
<br />
<br />GOMPANY
<br />I.E1TER
<br />COMPANV
<br />LETTER
<br />MY
<br />lETTfiR
<br />IlOlrAHY
<br />LETYllft
<br />CONPAI/V
<br />LO'l'nR
<br />
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOIlMATION ONLY AND
<br />CONFERS NO RIGHTS UF'ON THE CERTlFlCATE MOLDER THIS CERTlFlCATE
<br />DOES NOT AMEND, EXTEND OR At rER THE COVI!RAGE AFFORDED BY THE
<br />POLICIES BELOW,
<br />
<br />COMPANIES AFFORDING COVERAGE
<br />
<br />A EVANSTON INSURANCE COMPANY
<br />
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<br />1lft9 IS TO CEJrrI THAT THE POUCJI$ OF INSUlUNca Llano .aow HA~ ~ ~ 'r0 THI!! JNSUR~~ ~ Move ~~ THII"OLICY PfiRlOD INOICATED.
<br />HO'rWrrHSTANOU\IG AMY AlCIlIREMENT, f1iRM Oft CONDrTION.OF AN'f COf(rMCT OR O'TH&R OOCUMEN.T W1THIf:e$1!:CT TO WHICH Ttttl CEJlTWltcATfi M4V S&ISSUj;D
<br />OR WloY' PERT~. THIi "~&l.JR.t.NC1 NFOR[)EP BY 1111 POUCtES DEaC,... klJuilN Ie SUBJECT TO ALL THe TI!:~~ JiX-cLUStON AND COhtPlTlONS 01' SUCH POLICIES.
<br />LMTS Ii Y HAW IIftN "I!~D BY PAID
<br />
<br />CO
<br />LTR
<br />
<br />TYPII!: OF JNSUAANcE
<br />
<br />PDUCV NUMBefll
<br />
<br />
<br />GE~EAAL I.IA8.IL.ITY
<br />COMM~ GENERAL
<br />lIABILITY
<br />Cl.A1MS fXl OCCUR
<br />MAIlE ~
<br />OWNER.S" CONYAACTOR-S
<br />PROT.
<br />Gl. OED,S1 ,000
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<br />SllP300CHl5
<br />
<br />POLICY I!fFECTrvE I'OUCY
<br />DATE (-llO/I'Y) DPlItA"nON LIMlYa
<br />DATE MIWDIVY
<br />09129/05 09/29106 GENERAl.. AGGRlGAn NJA
<br /> PROOUOTs..cOMPIOP $1.000.000
<br /> AG
<br /> PER$ONAL $. ADV. INJLRY $1,000,000
<br /> EACH OCCURAl!HCE $1,000.000
<br /> FIRE DAMAGE (Ai;y on.",.) 51.000.000
<br /> MED, N5e WI, Me NlA
<br /> 09/29106 51.000.000
<br />
<br />A
<br />
<br />A
<br />
<br />AUTOIlO8lt.E I.lA*UTY
<br />
<br />Sl'PJOOo.05
<br />
<br />ANY AUTO
<br />AU. OWNED AUTOS
<br />SCHEOlJl.EO ALJTOS
<br />X H~O "vrOa
<br />X NOk-OWNECl AUTOS
<br />G.4.RAGE LJAAlI..ITY
<br />AUTOOEO: $1,000
<br />
<br />UMBRElLA FORM
<br />eTHER TJ.w.l UMBAEUA FORM
<br />
<br />
<br />~D1L Y tNJURY
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<br />Y ....lJRY
<br />~i.lCCIlIeru)
<br />PROPERTY OAMAOE
<br />
<br />APPROVED AS 0 FORM
<br />
<br />EACH OCCuARENCE
<br />AGGREGATE
<br />
<br />WORKER's COMPEHSATtON
<br />""D
<br />~PLOYlEfrli UABlLlTY
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<br />EAC:H ACCIDENT
<br />CIS &POlICY llMfT
<br />OISEASE.v.cH ."'Pc YEf
<br />
<br />A
<br />
<br />NON-PROFIT DIRECTORS
<br />AND OFFICERS
<br />
<br />SllPJOoo.o5
<br />
<br />09/29105
<br />
<br />09129106
<br />
<br />$1.000,000
<br />
<br />PeR OCCURRENCE AND
<br />ANNUAlAGGRfGAn;
<br />
<br />llM IONOFDn"ATlQHII TIOJrtlSNEhlClE.IISl1KlALrt1:MS
<br />
<br />AS RESPECTS TO THE COMMUNITY DEvELOPMENT 81.OCK GRANT, THE CITY OF SANTA ANA, rrs OFFICERS. AGENTS, EMPLOYEES AND
<br />VOI.UNTEERS SHAl.l BE NAMED AS ADDITIONAL INSURED. THIS INSURANCE IS PRIMARY AND ANY INSUAANCE OR SELF INSURANCe MAINTAINeO BY
<br />SUCH ADDITIONAL INSUREDS SHAll NOT CONTRIBUTE TO IT, ADDfTlONAl.INSUReD ENDORSEMENT ATTACHED. SUBJECT TO F'OI.ICYTERMS,
<br />CONDfTlONS AND ExCLUSIONS,
<br />
<br />I ':.::T~!'jj'f, " ,:".'.-:.1'.....' .,lr'Li'.';;.," ',:';.' ':,t,;I:'!'~:I.,';.iI"".1;','. '.',',:Il",".",:l,l~:\.",::"", :'.',~r ',<',.' '~,"'.',,\.': :-1,'.':,."':',,' ,:,':.,,'.', ',:11," '- >: ,"; ..T\...."t"::....:.~,'1r,: '(I~:"\'I ';',;~,'I,r~~.\:;;w, ,'M' _.Il"~ ,,~', .,~;';r,(~:;r'....i')..,..; :_,' :,,; :". '..',:,":..f ...... :.'.~.~. .
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<br />SHQUU) 4NY OF rHE ABOVE DESClIIBED POLICIES BE CANCELLED BEH>I<E rHE
<br />EXPIRATION OAr. THEREOF. Y'HE ISSUING COMPANY WII..L. ~)''''''''' ,...lOt TI:} MAlL
<br />~ PAYS WRITTEN NOTlCf TO rHE CERTIFICATE HOLDER NAMED TO THE LEFT.
<br />BUT FAILURe TO MAIL. SUCH NonCE S,fiAl.L IMPOSE NO OSI.IGATlON OR LlAall-l'J'Y
<br />Of ANY KIND UPON "'H~ COMPANY. ITS AGE"'TS OR REPRl:S~NTATfVES
<br />.E>:CEPT 1c:l ClAY$ FOR NON-PAYME:;NT
<br />AU HORIZEO AIIV
<br />
<br />CITY OF SANTA ANA
<br />COMMUN'TV DEVELOPMENT AGENCY M.~S
<br />20 CIVIC CENTER DRive
<br />PO BOx 19l11l
<br />SANTA AW.,QA 92702
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