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<br />'JUL 16 2002 9:07AM
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<br />HP LASERJET 3200
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<br />MAGUIRE INSUFt NCE AGEt-ICY
<br />LlC 10377645
<br />26:300 LA ALAME A SUITE 470
<br />MISSION VIEJO, A 92691
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<br />INIUItE"D
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<br />...... "'-" Pr -ZOt:);;-- I oS- - I '0
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<br />ACORD. (ERTIFICATE OF LIABILITY INSURANCE , 'OOi-f='
<br />THIS C~RTIACATE IS ISSLlED AS A MATTER OF INFORMATION
<br />ONLY AND CONFERS I/O R!GHTS UPON 1lJE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AliENO. EXTEND OR
<br />AL TER THE COVERAGE AFFORDED BY TilE POUCIES BELOW_
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<br />~-oa25
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<br />IN3UP.!;R .~
<br />
<br />lNSLlRERS AFFORDING COVERAGE
<br />~ILAlJELP..H'-"-INDEf>.INITY INSURANCE COMPANY.
<br />
<br />fEEDBACI, FOUNDATION
<br />1200 N. K OLLWOOD CIRCLE
<br />ANAHEIM CA 92B01
<br />,
<br />COVERAGES
<br />THE POUCIi::SQF INSU ANCE UBTEO BELOW HAVE B6EN.I&SUED TO THE I~StJRED NAMED ABOVE FOR THe pOtU";'( PER\OD INDK;,\,-ED. NOlWITHGTANOING
<br />ANY HEQlIIRE!lAENT. r RM OR CONorrrON OF ANY CONTRACT OR OTHF.R DOCUMENT WITH RESPECT TO WHICH THIS CERTlflCATI: MAY BE ISSUED ~
<br />M,Io,V PF.RTAIN, "THE INS RANCE AFFOrmED BY THE POLICIES DESCR1BEO HEREI'-I15 SUBJECT TO All. THE TERMS, [XQUSIONS ANO CONOlfrONS Of S\JC~
<br />_ _f"OLlCIES. AG_~_~~_~_~T~ L..ItAlTS SHOWN 'M_,!,V HA'\IE~EEIi R~O~C~?_BY PAID ~':"'~:, ,. - - ilfDNr-------.-n----. ...- -- --~------
<br />IUIR T'l'PE Of IN8U ~CE POLlCY "UIIo\'BfK ~ EFFI!CT1YE P UCV EKPfRfmL. LIMITS
<br />~Nl:RALLlIlo&ILITY ~~H,~~~~~~-m. _~_______J'OOO,O(X)__
<br />A 'lEX Xi! (COMMERCIALGEN '1ALUABILlrY PHPK027575 0710112002 07fOl/2003 ~~!!":~i~~~_ $ 10D,OC()._
<br />I Cl""M" MiADE [[]axuR i ~_~~~(~L~.fl''''lMl) $ ___~,OOO_
<br />___ PeRSONPJ..& Af.'N IrtJURY ~_ ____l,9091!Q!L
<br />~ _ _ _ QENERALAGGREGATE ~_ __ 2,000,000
<br />~~'~::,:~f~l ~;~I APr1-Ei ;;; ~~!?-~~~~~~-~ ~ -- - - _~~~~900
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<br />~~ER~.__~.. _
<br />INSUReR c:
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<br />INSl..lRfflt:::
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<br /> o\UTOMOBlLE' UAPlllTT I
<br /> COMetN!;O SINGLE UMH , 1,000.000
<br />A A "NY "uro PHPK027575 0710112002 0710112003 {Egace~IJ
<br /> --------
<br /> ..~ All OWril;D AurO eOOll'( INJURY
<br /> 5CHt::U ULED Aura [f'O'~) .
<br /> - ------~.---- -----~.
<br /> i"',~AUT06 5Q[1llV IN,IURY
<br /> N{)Io. OWNED ALlTO (P4/.acc100n'. .
<br /> - --------- . .- ._~
<br /> -- ------- - ...- PROPERTY IJ,I:.11II"GE ,
<br /> (PClfacd.Jent)
<br /> ~"G' u...'''' .A.lJTO ONl V - EA ACCIDENT ,
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<br /> 4NVAUTO "THEn '1-"AN EAACC', . ..-
<br /> AIJTOONI.Y: AGO .
<br /> E.XCiS5 UUILITY EACH OCCIJRRCN:E . 1,000,000
<br />A :AJ OCCUR o ctAIMS MADE PHUB010926 0710112002 0710112003 ~F.~!"'.~_. . 1,r.KlQ.,OOO.
<br /> .----
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<br /> =1 DEOUCIBLE e--- -----~- .
<br /> 0,000 ----.- .~ ----------
<br /> Rl:.1ENT1ON , .
<br /> ...oM-ERa COMPEN&A OK "-NO ~~Rilf~I__ IVtP-
<br /> !!Ml'"lOYEJU'I'LltIUilUTY
<br /> E.L EACH .a.rXIUF.tH I ------
<br /> E.t..DI:3EPSt'-EA[MPWY~E S --
<br /> EL DlSF.A.'''E - POliCY LIMn ,
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<br />A CRIME PKPK027575 0710112002 0710112003 EMP DISHONESTY $100,000, $~ ,000 DED
<br /> I THEFT IN/OUT $1,000, $250 OED
<br />
<br />DEaCRlPt10N OF DPERA110JIIFtLOCATIO~Sl\tElEUlS1EXClUtlIO"SAtCl!D illY fJlOORSEM&.NTmpI!CIAL pROV1610NS
<br />CITY OF SANTA AN ,ITS OfFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE INCLUDED AS ADDITIONAL INSURED AS
<br />RESPECTS THE OP RATIONS OF THE NAMED INSURED.
<br />
<br />CERTIFICATE HOLD
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<br />I X I ADD1TlQNAl.INSUPCD; IMllUftER LE1"Iet: X
<br />
<br />CANCELLATION
<br />
<br />'CITY Of )ANTA ANA
<br />COMMU ITY DEVELOPMENT AGENCY M-25
<br />P.O.80 1988
<br />S"toIT A I A. CA 92702
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<br />ACORD 2!l-S (7117)
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<br />BHOUl-DAflYOFTHI!.UDVE DUCRI9EOPClUCIESBE CAMCELLED 8EF<:1FlE nlEflCf'lRATlON
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<br />DA'I"E "T1IaJlEDF, THE atJlNG Wo/&t1RU. Wll...~ll __ "30 DAYS W'R1TTI!!Il
<br />
<br />NCTlCE1Q THI!! CER11F1C,\TEttQLD!RNANSI)TO THELI'!PT~
<br />~"""'"'''lloll."folNl>'''''''
<br />
<br />AtJ1HORlZl!D Rl!P',.DENTA.TNE
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<br />xXXXXXXXXXXXXXXX
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<br />LJ:. 'v no "'-
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<br />" AOR:D CORfORA TION 198B
<br />
<br />Ad-ROVED AS TO FORNi
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<br />~I
<br />\ 11[::\ Sheedy (
<br />pl:t:-,; City Attorney
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