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w <br />A f %f%0 % <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MM /DD/YYYY) <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />06/28/2010 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS 'UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Comprehensive Insurance Services <br />22342 Avenida Empresa <br />Suite 255 <br />RSM , CA 92688 <br />ONTACT <br />NAME: <br />PHONE (849)709 -8800 FAX <br />ac No Ext : ac No): (949) 709 -1668 <br />E -MAIL <br />ADDRESS: <br />PRODUCER <br />CUSTOMER ID #: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />INSURERA: NONPROFITS' INSURANCE ALLIANCE 0 <br />CA <br />INSURER B, <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE FK OCCUR <br />Mental Health Association of Orange County <br />INSURERC: <br />822 Town & Country Rd. <br />INSURER D: <br />$ 500,000 <br />Orange, CA 92668 <br />INSURER E: <br />A <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: GL AUTO REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSR <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM /DD/YYYY <br />POLICY EXP <br />MM /DD/YYYY <br />LIMITS <br />SANTA ANA, CA 92701 <br />GENERAL LIABILITY <br />2010-08472 -NPO <br />07112/2010 <br />07/12/2011 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE FK OCCUR <br />D <br />DAMAGE PREMISES Ea occurrence <br />O RENTED <br />$ 500,000 <br />ME EXP (Any one person) <br />$ 20,000 <br />A <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />PRODUCTS - COMP /OP AGG <br />$ 2,000,000 <br />POLICY JEPRO X LOC <br />CT <br />$ <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />2010- 08472 -NP <br />07/12/2010 <br />07/1212011 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />A <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />I!I <br />- <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />NON -OWNED AUTOS <br />$ <br />$ <br />UMBRELLA LIAR <br />X <br />OCCUR <br />2010-08472 -UMB -N <br />07/12/2009 07/1212010 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />A <br />EXCESS LIAR <br />CLAIMS -MADE <br />voo <br />AGGREGATE <br />$ 2,000,000 <br />DEDUCTIBLE <br />$ <br />`Q <br />O <br />X <br />RETENTION $ 10,000 <br />Kt7 <br />$ <br />WORKERS COMPENSATION <br />WC STATU- OTH- <br />AND EMPLOYERS' LIABILITY YIN <br />TORY LIMITS ER <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory In NH) <br />If DESCRIPTION OF OPERATIONS below <br />NIA! <br />��gA G, <br />t'G1n <br />ORCK <br />y kttol a <br />I <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mores ace Is required) <br />ERTIFICATE HOLDER IS NAMED AS ADDITIONAL PER ATTACHED AGREEMENT <br />"EXCEPT 10 DAYS FOR NON- PAYMENT <br />CERTIFICATE HOLDER CANCELLATION <br />C 1988 -2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />CITY OF SANTA ANA, ITS OFFICERS, AGENTS AND <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />EMPLOYEES <br />AUTHORIZED REPRESENTATIVE <br />ATTN: FRANK HERNANDEZ <br />20 CIVIC CENTER PLAZA, M -25 <br />SANTA ANA, CA 92701 <br />Richard Eynon, CIC /JEREMY <br />C 1988 -2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD <br />