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<br /> <br />PRODUCER <br />Driver + Allianllnsurance Service$, Inc. <br />P.O. Box 25884 <br />Santa Ana, CA 92799 <br />(800)821-9283 Ex!. 190. Fax 1949) 756-2713 <br />Liceny No. 0C;3&Wl1 <br />INSURiO SPECIAL l...WfIU'rY INiJJAAMCE PROGRAM ~LIP) MliiMBE:R: <br />FAMII.IES TOGETHER OF ORANGE COUNTY ,4-,;/004 -;;1..0 I <br />801 S. ~ YON ST. <br />SANTA ANA, CA 9270. ~ ~. ..20;1... <br />A- ~iYf-;)'tJ[ - 01 <br />A-a.OC)4-cw~- 0/ <br /> <br />/h:X5t:.o -07,1'-0/<1- <br /> <br />T-4TO P.02/0, F-547 <br />'''''....~-''...\''"''.......,I 'I <br />1 0/6/05 <br /> <br />CQIoI'AHY <br />LETTER <br />COl4P.w; <br />LETTER <br />HlY <br />LETTER <br />eOMPANY <br />LETTIlIt <br />CONPANY <br />lEYYER <br /> <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ON~Y AND <br />CONFERS NO RIGHTS UPON THE CERl1F1CATE 1iO~0ER. THIS CERl1F1CATE <br />DOES NOT AMEND, EXTEND OR A~ TER THE COVERAGE AFFORDED IlY THE <br />POLICIES BELOW. <br /> <br />COMPANIES AFFORDING COVERAGE <br /> <br />A EVANSTON INSURANCE COMPANY <br /> <br />B <br /> <br />C <br /> <br />o <br />E <br /> <br />nfiS IS TO CERTIf!\' T~T THI!: POUCIIS OP INSufltANcI! LI$TIiO ISLOW HAVE BEDlISSUIO '1"0 THe INSURliO KNlED MOV"r: Jll"Oft T" POLICY Pl!RtoO INOICATED,. <br />NO'rWITHSTAHDtNG AI('( AEOuIREMENT, TliRM OR CONDITION OF AN'( COtrrIU.cT CRamER OOCtR<<Hr 'MTHRlZSf'ECT TO WHK:H TI'tII C~Ti MAY ~ IhUED <br />OR: M.A.Y "RTNH. THE INSurtA.NC1 AFFORDI!:IJ .., "toIII POUQU DI!aCIUIP I1IftllN NI SUBJ&CT TO ALL THE rER" DQ,u$lON AND CO~NS OF SUCH ~lelES. <br />LIMITS Y .....Wl!l!l!N ftil!OUCl!:D BY PAt[) CLAIMt. <br /> <br />CO <br />LTR <br /> <br />TYPE OF INSURANcE <br /> <br />PDLICV NUWBe,. <br /> <br /> <br />GENERAL 1.1ASI1.1TY <br />CQMMeF<<:;1Al GENERAL <br />lIABILITY <br />Cl,AIMS ~ OCCUR <br />MADE ~ <br />OWNER'S &; CONTRACTORS <br />PROT. <br />GL OflD,Sl.000 <br /> <br />SLIP3000-05 <br /> <br />POLtOyefFECTIVE <br />D"nl_~ <br />09/29/05 <br /> <br />I'CL.lCV <br />IDCPlAA'nON <br />TE MWlDDIVV <br />09/29/05 <br /> <br />~a <br /> <br />A <br /> <br />A <br /> <br />AlJTOUOBlU UAalUTY <br /> <br />SLIP300~05 <br /> <br />09 <br /> <br />GE!NERAL .AGGRSGATE <br />PROOUC~OMPtOP <br />AGG. <br />PER$ONAL il AOV. INJURY <br />EACH OCCURRSNCE <br /> <br />F'I\S CAMAG&: (Ally ono 11...) <br />MEW. ~MSe CM" OM <br />""" <br /> <br />N1A <br />$1,000,000 <br />$1,000,000 <br />$1,000,000 <br />$1,000,000 <br />N/A <br />$1,000,000 <br /> <br />09/29106 <br /> <br />ANY AlITO <br />AU. OWNED AUTOS <br />SCHE.OuLSO AUTOS <br />X 1ol1REO "UTOS <br />X NOk.oWNeo AUTOS <br />lMAAGG: IJA8n..I'rr <br />AUTO OED: $1,000 <br /> <br />UMBRELLA FORM <br />OTHm TI-wl UM8~UA FORM <br /> <br /> <br />~OIL V INJURY <br />~rper-..ool <br />BODILY IHJURY <br />(Per OIl;Qdenll <br />PFlOPlORTY MA~E <br /> <br />APPROVED AS 0 FORM <br /> <br />EACJ1 OCCuRRENCE <br />AGGREGATE <br /> <br />WORkER's COMPri.N$AT'ION <br />"'D <br />.er.tPI.OVER'1i UABIl.ITY <br /> <br />'_~,~L,.;u~~-" w......~_~ .~ .~~ <br />~"'-,,. <br /> <br />lEACH ACCIDENT <br />DJSE.\S;'POUCV LIMIT <br />DtSeASEofACH EMP-oYliE <br /> <br />A <br /> <br />NON-PROFIT OlRECTORS <br />ANO OFFICERS <br /> <br />SLIP30CJO.OS <br /> <br />09/29/05 <br /> <br />09/29f06 <br /> <br />$1,000,000 <br /> <br />peR OCCURRENCE AND <br />ANNUAL AGGREGATE <br /> <br />llQ~IONOFOJOERAt1 NSll.OCATJON:sNEklCL <br /> <br />t.lW.trtMi <br /> <br />AS RESPECTS TO THE COMMUNITY DEvELOPMENT IlLOCK GRANT. TIiE CITY OF SANTA ANA, rrs OFFICE:RS, AGENTS, EMPLOYEES AND <br />VOLUNTEERS SHALL BE NAMED AS ADOITIO~ INSUREO. THIS INSURANCE IS PRIMARY AND ANY INSURANCE OR SELF INSURANCE W.INT AINEO IlY <br />SUCH AODITIONAl.INSUREOS SHAll NOT CONTRIBUTE TO IT, ^OOfTIONAl.INSUREO ENDORSEMENT ATTACHED. SUBJECT TO POLICY TERMS, <br />CONDITIONS AND exClUSIONS. <br /> <br />CITY OF SANTA ANA <br />COMMUNITY DEVElOPM~NT AGENCY M-2S <br />20 CIVIC CENTER DRIVE <br />PO BOx 1911B <br />SANTA AW.,CA 92702 <br /> <br /> <br />SHOUl.D 4/lY O~ THE ABOVE OESCRIBED POUCIES Be CANCEl.LEO BEFORE THE <br />EXPtRAnON OA'niTHEREOF. THE I$$UING COMPAP\fY Will. ~rJ"''''''~''''q TD MAlL <br />"30 DAYS WRITTeN NOTIC~ to THE CERTIFICATf; HOLDER NAMED TO THE LEFT, <br />BUT FAILURE TO MAIL ~UCH NOTICIE SHALL IMPOSE NO O$I.IGATlON OR UAall-l'tY <br />OF ANY KIND UPON THE COMPANY. ITS AG~I'IITS OR REPIU~NTATIVIiS <br />.EXCe:PT,O OAY$ FOR NON.PAYM!::NT <br />AU ORIZEO A TIV <br /> <br />lil1llllolll'..:r.H1 <br /> <br />..--..... <br /> <br />~!1I.1I'i'~""~ltI\IlIo'lroll 111\:'~~ <br /> <br />.. <br /> <br /> <br />... <br /> <br />--..-.--...-...... <br />