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FrOrc.: C11ap~nan Cert Request At: Chapman Insurance FaxID: Chapman Assodates To: Lucy Floret ,t "' <br />_ _:I,: :r <br />ACORD CERTIFICATE OF LIABILITY INSURANCE VIETN ~ ~ '-Sii/ze~a--.. <br />Chapman & Associates A-2008-069-69 <br />License #0522024 <br />P. O. Box 5455 <br />Pasadena CA 91117-0455 <br />Phone:626-405-8031 Fax:626-405-0585 <br />Vietnamese Community of Orange <br />I ma laKl rrlcAfE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND dR a <br />ALTER THE COVERAGE .AFFORDED BY TuE PCrI^IGIES BELOW-, <br />INSURERS AFFORDING COVERAGE +~4~C• <br />INSURER A: Nonprofits' Insura::::e _ <br />INSURER 6: North ANQr1C>n 6'.~-~a _'o:n:ra r,~~;~ <br />C01171tyy INSURER G <br />1618 A. First Street INSURER D: <br />Santa Ana CA 92703 _. __ __ .. -. ' <br />._ .. _ <br />INSURER E: <br />COVERAGES ------~ --- <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIO i' P=21GD IC`.D!C :T=r r- M -~A~pl, ~ `-M <br />ANY RECIUIREMENT, TERM OR CONDRION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESP_CT TO L'JHICH T tE .' _~- ,CST= Gt r;-_ <br />MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. FC .:: n= .;~, ~ r..~ - <br />POLICIES. AGGREGATE LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ~ ~ ""'" <br />LTR NS TYPE OF INSURANCE POUCY NUMBER DATE !DD (RATION' <br /> <br />GENERAL UABLRY GATE A4~DNY LIMT: <br />-__. <br /> ESi:H CCC'JHRENCi- <br />lOOQOOO ' <br />• <br />A X X COMMERCIAL GENERALLIABiLI7Y 200704575 10/04/07 10/04/08 _._-..; <br />PREMSES!Fa:r~ <br />~ <br />~.r'~ 1000OC. <br /> <br />CLAIMS AMDE X OCCUR . <br />.. <br />I .__ __ .. <br />- <br /> ~GIFU E}'I <br />:.A,r, :n;,.-,-::r IOOOO <br /> X Abuse Liab 1P4I <br />T'FFtSON;1 .9t1:= yl,!- lcoooo <br /> <br />X <br />Soc Svc Prof 1M o <br />c,FriEk <br />~~RFC t ~OOOCC <br />' <br /> GEN'LAGGREGATELIMITAPPUESPER ~ <br />. <br />O <br />' <br /> <br />PRO- °F <br />:DUtl JF.1P r'h G 2000OCO <br /> POLICY <br />JECT LOC _. ...._ . __-----`-~ - <br /> AUT OMOBR.E LIABILITY ---.._..__.. ___,___~_.i <br />A X ANYAUro 200704575 10/04/07 10/04/08 <br />' '.:I000C% <br />~ jF"°" "'' <br /> ALL OWNED AUTOS ~----'-----._.. _ .____ __ _ _._..__ <br /> <br />SCHEDULED AUTOS BOIiiI` N.IUR'~ <br />(p~,r pa!-,.;; , " <br /> X HIRED AUTOS -- -~ - - <br /> X NON-OWNED AUTOS 6GD~L~ NJUR" <br />jeer acciramj <br /> <br /> <br /> GARAGE LIABILITY <br />-_ _..,: <br />'"'--°.-.^- <br /> ,. . <br /> ANY AUTO ----.- ._. ...._._.__-_._.-__._..__j <br /> OTHEP, iI V.N -' <br /> <br /> EXCESSNMBRELLALUIBILRY ----- ----- <br /> I E~~CH OCC!.iRREN(1F <br /> <br />OCCUR CLAIMS MADE e <br />-~~~ ~----~-~~^^~ <br /> ACGRECr`~,LF <br /> <br />~ -----. <br />~ <br /> DEDUCTIBLE ' ---------- ~--._ _---------I <br /> RETENTION S - '-'---~- -- ---------. _~--- <br /> WORKER9 COMPENStATION AND ~ ~~ , --'--------. <br />~ <br /> EMPLOYERS'LU161LTR' <br /> <br />ANY PROPPoETOR/PARTNER/EXECUTIVE ~ -TGR~1111T~ ~ i <br />-, <br />- _. ----... _ _. - --f <br />F E ;:I A L DEN! <br /> OFFICER/MEM6EREXCLUDED? - - i <br /> Il yes, tlescrae under E. D:~FKSF r~: FP.IrI :,. <br />- <br /> <br />SPECIAL PROVISIONS6ebw ....._.....----~-------i <br />--- <br /> <br />OTHER Ft. DISFf.SF p(ili` •'I I <br /> <br />B Crime CWB00019270504575 10/04/07 10/04/081 Emp Dishc 1000OC• <br />Forgery 10000E ' <br />DESCRIPTION OF OPERATIONS f LOCATIONS 1 VEHICLES / IXCLUSION9 ADDED BY ENDORSEAE <br />"-' ~ " ~~-"-" " <br />NTI SPECIAL PROVISIONS <br />"" "" "'- <br />City of Santa Ana, its officers, employees, agents, volunteers and <br />representatives are named additional insured with respect to the operations <br />of the named insured per the attached CG 2026 endorsement <br />Such i <br />j <br />. <br />nsurance is <br />primary and non-contributory. 10 days notice of cancellation for non-payment: <br />of premium. XX <br />CERTIFICATE HOLDER rwur~~ ..~~...~ - <br />CTYSTNA 8NOULD ANY OF THE ABOVE DESCRIED POLICIES aE CANCELLEC BFAgRE THE EXRIRAT!G^~ <br />DATE THEREOF, THE ISSUNG INSURER'NIL.L~pll 3(r DA'rS 1VRI'?Eh: ; <br />NOTICE TO THE CERTF KATE HOLDER NAMED TO THE LEFT, <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 AUT D REPR NTA _~ - ---- ._ _. ___._ ___ __. . •. <br />~~.~ <br />ACORD 25 {2001/08) I=- AGC}RF+ c;ORPORATiOh ' <br />