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`ACORD CERTIFICDTF OF LIABILITY INSUR J*+ E <br />PRGDUCEP (G26) 599-8830 FAX �u_b) 599-8831 THIS CERTIFICATi .d 1„cSUED AS A MATTER <br />Pacific General Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE <br />HOLDER. THIS CERTIFICATE DOES NOT AM <br />405 E. Santa Clara Street ALTER THE COVERAGE AFFORDED BY THE <br />Suite 100 <br />Arcadia, CA 91006 INSURERS AFFORDING COVERAGE <br />Mexican American Opportunity Foundation INSURERA. Philadelphia Insurance <br />401 N. Garfield Avenue INSURERB: <br />Montebello, CA 90640 �-�G'I INSURERC <br />INSURER D: <br />DATE (MM/DO/Yyyy) <br />NAIC # <br />OR <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 />INS9 <br />LTR <br />kw <br />NSRE <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MM/DD/Y1' <br />POLICY EXPIRATION <br />DATE M <br />LIMITS <br />GENERAL LIABILITY <br />PHPK108178 <br />01/30/2005 <br />01/30/2006 <br />EACHOCCURRENCE <br />$ 1 000 <br />X COMMERCIAL GENERAL LIABILITY <br />PREMISES Eaoecurepce <br />$ 100,0 <br />CLAIMS MADE 1�1 OCCUR <br />MED EXP (Any one person) <br />$ 5 <br />PERSONAL L ADV N IURy <br />t i, DOD, use <br />n <br />X <br />GE�- <br />3,000,0 <br />GEN'L$ <br />AGGREGATE LIMB APPLIES PER: <br />PR <br />$ 3, 000,0 00 <br />X POLICY n JECO7' nLOC <br />AUTOMOBILE <br />LIABILITY <br />PHPK108178 <br />01/30/2005 <br />01/30/2006 <br />COMBINED SINGLE LIMIT <br />X <br />ANYAUTO <br />(Ea acadenp <br />$ <br />1,000,0 <br />ALL OWNED AUTOS <br />BODILY INJURY <br />SCHEDULED AUTOS <br />(Per Person) <br />$ <br />A <br />X <br />HIREDAUTOS <br />BODILY INJURY <br />$ <br />NON -OWNED AUTOS <br />- <br />c[acaeenl) <br />PROPERTY DAMAGE <br />$ <br />(Per acadenl) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />ANY AUTO <br />OTHERTHAN EA ACC <br />b <br />AUTO ONLY: AGG <br />$ <br />EXCESSA/MBRELLA LIABILITY <br />AC <br />EH OCCURRENCE <br />b <br />OCCUR ❑ CLAIMS MADE <br />AGGREGATE <br />$ <br />APPROVE AS <br />O FORM <br />a <br />DEDUCTIBLE <br />a <br />RETENTION $ <br />Z <br />a <br />WORKERS COMPENSATION AND <br />;lira Slit Sh <br />Cdy <br />EMPLOYERS' LIABILITY <br />TORY LIMITS ER <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />AI,v� <br />I1GV <br />OFFICERGAEMBER EXCLUDED' <br />If yes, desape under <br />'--'-•" " V <br />E.L. DISEASE - EA FMPI OYEE <br />S <br />SPECIAL PROVISIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />OTHER <br />rime Coverage <br />PHPK108178 <br />61/30/2005 <br />01/30/2006 <br />See Below <br />A <br />rofessional Liability <br />PHPK108178 <br />01/30/2005 <br />01/30/2006 <br />$1,000,000 OCC/$3,000,000 OCC <br />UESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />he City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as <br />dditional insured as respects to claims arising out of the operations and uses performed by or on <br />ehalf of the named insured. <br />ten day Notice of Cancellation shall be given in the event of non-payment of premium. <br />City of Santa Ana <br />Community Development Agency (M-25) <br />Attn: Carla Thompkins- Mngt. Aide <br />P.O. Box 1988 <br />Santa Ana, CA 92702-1988 <br />V SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL N)00( '\VVI MAIL <br />_3g_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />K9C70E)FX�(9PrbD6lX5f9EKx90(9iif3C+X9E10170ff7(ltSilQl(919(9Q7AM0(9(-k9@K)0(XX <br />1 Martin <br />25 /2001/OR1 <br />i <br />