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Home My WebLink AboutROMAN CATHOLIC BISHOP -2004 -, ACORDm CERTIFICATE OF LIABILITY INSURANCE I DATE IMM/DDNYYV) 04118/05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur J. Gallagher & Co. Ins. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Brokers of CA Inc Lic.#0726293 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. One Market Spear Twr Ste 200 San Francisco, CA 94105 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: The Ordinary Mutual, a R.R.G.C. 10171 Roman Catholic Bishop of Orange INSURER B: P.O. Box 14195 INSURER c: Orange, CA 92863 A -"~'O+-/,/'-I INSURER D: INSURER E: Client#. 1502 CA THORA COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE PQUCY NUMBER PDo..t~~:~~8~~IE Pg~W/~'::b~~N LIMITS A ~NERAL LIABILITY CGAL0042004 07/01/04 07/01/05 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE 19F~~NTED $50 000 l CLAIMS MADE [Xl OCCUR MED EXP (Anyone person) $5000 - PERSONAL & ADV INJURY .1 000 000 - GENERAL AGGREGATE $2 000 000 ~'L AGG~nE LIMIT APrilS PER: PRODUCTS. COMP/OP AGG $2 000 000 POLICY ~~8T. X LOC A ~TOMOBILE LIABILITY CGAL0042004 07/01/04 07/01/05 COMBINED SINGLE LIMIT ~ ANY AUTO (Eaaccident) $1,000,000 - ALL OWNED AUTOS BODILY INJURY (Per person) $ - SCHEDULED AUTOS ~ HIRED AUTOS BODILY INJURY $ ~ NON..{)WNED AUTOS (Per accident) - PROPERTY DAMAGE . (Pereccident) ==iAGE LIABILITY AUTO ONLY. EA ACCIDENT $ ANY AUTO OTHER THAN EAACC $ ~ ~~ 'CADI1\A AUTO ONLY: AGG $ ~ESSIUMBRELLA LIABILITY Al'l"KVV= f'GY EACH OCCURRENCE $ OCCUR D CLAIMS MADE .....;-r! / /'- AGGREGATE $ /-"'-/'''~_/- .!'. / , , $ =i ~EDueTIBLE , Laura St tt Sheedy $ RETENTION $ ^ ""istant ity Attorney $ WORKERS COMPENSATION AND I we STATU-, I IOJ~- EMPLOYERS'L1ABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYE $ ~P~~I~~~~~v~~16~s below E.L. DISEASE. POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RE: Hispanic Ministry, 2811 East Villa Real Drive, Orange, CA 92867 as respects use of Santa Ana Stadium facilities for Conference/Charismatic Renewal Diocesan Movement on May 14 & 15, 2005. The City of Santa Ana, its officers, agents, employees & volunteers are named as Additional Insured per attached endorsement. CERTIFICATE HOLDER CANCELLATION City of Santa Ana, its officers, agents, employees & volunteers 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL E~IL --30..... DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, B~I.OUUll'lMXXX 1:JIRJtJDuIII._".~~.tl~"'JCDallGlJOIlkOIkX lIIIBNR..,.,JID9O( AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) 1 of 2 #S134802lM123829 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain pOlicies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the pOlicies listed thereon. ACORD 25-5 (2001/08) 2 of2 #S134802lM123829 . ....... ADDITIONAL INSURED ENDORSEMENT Insurance Company The-Ordinary Mutual, a R.R.G.C. This endorsement modifies such insurance as is afforded by the provisions of Policy # CGAL0042004 relating to the fqllowing: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701 j its officers, employees, agents and volunteers are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses.performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be canceled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, inclUding countersignature, is required to make this endorsement effective.) Effective 04/18/05 , this endorsement form as a part of Policy # Issued to CGAL0042004 Roman Catholic Bishop of Orange APPROVED AS TO ------!~ . ". .! -, L:~-1 :~ I '-- Laura Stitt Shct:dy ~-'.:\i"t:ln[ City !\[I'II'nn Named Insured FOR'd~. ,~~ tr\ I H-a-' , ~ U /''--'('\.. .Countersigned by' ), Authorized Signature blil ':11:)'0.-1 39N~~0 ~O 3538010 61:0E-1:81: PLL PE:91 9001:/91/P0 ACORD," CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDfYYYY) 10/14/2005 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur J. Gallagher & Co. Ins. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Brokers of CA Inc Lic.#0726293 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. One Market Spear Twr Ste 200 San Francisco, CA 94105 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A The Ordinary Mutual, a R.R.G.C. 10171 Roman Catholic Bishop of Orange INSURER B: A Corporation Sole INSURER c: P.O. Box 14195 INSURER 0: A. ~ ,- - 44 Orange, CA 92863 "ill J::) - 14 INSURER E" Client#. 1502 CATHORA COVERAGES -. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERJOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH r~!lii~ts. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. T TYPE OF INSURANCE POL.ICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A ~NERAL L1ABIUTY CGAL0042005 07/01105 07/01/06 EACH OCCURRENCE '1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED .50 000 l CLAIMS MADE [Xl OCCUR MEa EXP (Anyone person) .5000 "- PERSONAL & ADV INJURY .1 000 000 "- GENERALAGGREGATE .2 000 000 n'L AGG~EnE LIMIT API~~tIPER: PRODUCTS. COMPfOP AGG .2 000 000 POliCY ~~Ei X LOC ~OMOBILE LIABILITY COMBINED SINGLE LIMIT . ~ ANY AUTO (Eaaccidenl) ~ ALL OWNED AUTOS BODILY INJURY . SCHEDULED AUTOS {Per person) e- I- HIRED AUTOS BODILY INJURY . I- NON-oWNED AUTOS (Peraccidenl) e- PROPERTY DAMAGE . (peracddenl) RRAGE LIABILITY AUTO ONLY- EA ACCIDENT . ANY AUTO OTHER THAN EAACC . AUTO ONLY: AGG . ~ESSlUMBREl.LA LIABIl.ITY EACH OCCURRENCE . ~ OCCUR D CLI.\IMS MtDE AGGREGATE . . R DEDUCTIBLE ^: L ~:_ . . ./ .. i~-,,- i :..~; , RETENTION I . WORKERS COMPENSATION AND k1 ;:I~ ~,I-!fI 1...~~5!~T'!;!;.1 IO,I,ti- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT . ANY PROPRIETORlPARTNERlEXECUTIVE -"-- t:wra ---.-,. OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYEE $ If yes, describe llnder "j;,l;!,lt Ci, ' E.L. DISEASE. POLICY LIMIT . SPECiAl PROVISIONS below OTHER DESCRIPTION OF OPERATIONS Il.OCATIONS! VEHICL.ES I EXCLUSIONS ADDED By ENDORSEMENT I SPECIAL PROVISIONS Re: 51. Joseph Church, 727 N. Minter Street, Santa Ana, CA 92701. As respects Parish Fiesta, facility to be used: School Yard & Hall, 608 Civic Center De., East, Santa Ana, CA on October 10 to 14, 2005 at 5.10pm; Oelober 15, 2005 at 2.1 0:00pm and October 16th, 2005 at 2.9:00pm. (See Attached Descriptions) City of Santa Ana, Its officers, agents, employees, representatives, volunteers 20 Civic Center Plaza Santa Ana, CA 92701 CANCELLATION SHOUL.D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELL.ED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WIl.l. ENJI~IL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, B~RftJI.n~x _...x.....,.kD:NDDCIIX.UDIDI.~~ afDX!lXX x CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) 1 of 3 #S143669/M137516 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAtVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer. and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ... ~P,,-OVc,iJ !:...l , '~l Z-Ir A~~l" )! t '11 \ \ ACORD 25-5 (2001/08) 2 of 3 #S143669/M137516 OESCRIPTIONS ~CC)t'l om Page 1} City of Santa Ana, Its officers, agents, employees, representatives, volunteers are named as additional Insured per the attached endorsement CG20261185. A.I' :":~V) \! -".::) /" Ol~J.' ~_~Jtf ._--....... ,~cJ}' I._~,,~.; .i., i.../dj .\ l ;'Jr:":,cy AMS 25.3 (2001108) 3 013 #S143669/M137516 POLICY NUMBER: CGAL004200S COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED. DESIGNATED PERSON or ORGANIZATION This endorsement modifies insurance provided under the fOllowing: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City of Santa Ana, its officers, agents, employees, representatives, volunteers 20 Civic Center Plaza Santa Ana, CA 92701 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your operations or premises owned by or rented to you. Re: St. Joseph Church, 727 N. Minter Street, Santa Ana, CA 92701. As respects Parish Fiesta, facility to be used: School Yard & Hall, 608 Civic Center De., East, Santa Ana, CA on October 10 to 14, 200S at S-10pm; October IS, 200S at 2-10:00pm and October 16th, 200S at 2-9:00pm. City of Santa Ana, its officers, agents, employees, representatives, volunteers are named as additional insured per the attached endorsement CG2026118S. PRIMARY INSURANCE: IT IS UNDERSTOOD AND AGREED THAT THIS INSURANCE IS PRIMARY AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED SHALL BE EXCESS ONLY AND NOT CONTRIBUTING WITH THIS INSURANCE. ..1'~UV..ol) AS TO F". ---I~ II Ii---.. Ll~~t, " .,'"l:::E City ,rd:lJj ...:y CG 20 26 11 85 -. CERTIFICATE OF LIABILITY INSURANCE . ACORD", I DATE (MMlDDIYYYY) 10/26/2005 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur J. Gallagher & Co. Ins. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Brokers of CA Inc Llc.#0726293 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. One Market Spear Twr Ste 200 San Francisco, CA 94105 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A, The Ordinary Mutual, a R.R.G.C. 10171 Roman Catholic Bishop of Orange INSURER., United States Fidelity and Guaranty 25887 P.O. Box 14195 INSURER c: Orange, CA 92863 INSURER 0: A-'2.M4- 1<\4. INSURER E: -Ciient#: 1502 CATHORA COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ~ = TYPE OF INSURANCE POLICY NUMBER P U EFF VE Pg~~,\" UMITS A GENERAL LIABILITY CGAL0042005 07/01/05 07/01/06 EACH OCCURRENCE $1 000 000 c- DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY $50 000 I CLAIMS MADE [K] OCCUR MED EXP (Anyone Person) $5 000 "- PERSONAL & ADV INJURY S1 000 000 GENERAL AGGREGATE $2 000 000 - ~'lAGG~En LIMIT APrilS PER: PRODUCTS - COMP/OP AGG $2 000 000 POLICY j~8T X LOC A ~TOMOBILE UABILlTY CGALOO42005 07/01/05 07/01/06 COMBINED SINGLE LIMIT X ANY AUTO (Esaccidenl) $1,000,000 ~ - ALL OWNED AUTOS BOOIL Y INJURY (Per person) $ SCHEDULED AUTOS - - HIRED AUTOS BODilY INJURY {Per accident) $ - NON-OWNED AUTOS PROPERTY DAMAGE $ .'On12M (Per accident) , d ,'.. ~ ,.j , RRAGE UAelLlTY , AUTO ONLY. EA ACCIDENT $ ANY AUTO 1A:3/~~ r' 4 /l~ OTHER THAN EA ACC $ AUTO ONLY: AGG $ ~ESSAlMeRELLA UABlUTY a(,li.\ y, .' J:; EACH OCCURRENCE $ OCCUR 0 CLAIMS MADE As bla.ll C'd_Y At OL.ey AGGREGATE $ $ q DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND D215WOO011 11/13/04 11/13/05 X I T'f{&J~~iis I _ jOJii. EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNERlEXECUTlVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $1,000,000 If rn' describe under E.L. DISEASE - POLICY LIMIT $1,000,000 S ECtAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCAOONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROYlS10NS Re: Mater Del High School, 1201 West Edinger Avenue, Santa Ana, CA 92707. As respects 2005.2 School Year, Faculty & Staff Parking lot on the corner of Orchard & Bristol, Santa Ana, CA from 6:30am. 6:00pm. City of Santa Ana, Its officers, employees, agents, volunteers and representatives are named as additional Insured per the attached endorsement. CERTIFICATE HOLDER City of Santa Ana cia City Clerk Office 20 Civic Center Plaza Santa Ana, CA 92701 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCEUED BEFORE THE EXPIRATlON DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ....3Q.... DAYS WRITTEN NOTICE TO THE CERTlACATE HOLDER NAMED TO THE LEFT, BUT FAIWRE TO DO SO SHALL IMPOSE NO OBUGATlON OR UABlUTY OF ANY KIM> UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Ii) ACORD CORPORATION 1988 /WCy ACORD 25 (2001108) 1 of 2 #S144140/M137519 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and condijions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement( s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not consiitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does ij affirmatively or negatively amend, extend or aijer the coverage afforded by the policies listed thereon. AT /,' TO FORM ------- ~Jh -;;~y..:Jy h~_-,.,[:,i. I.--.ij' A.Uor'.ey ACORD 25-S (2001/08) 2 of 2 #S144140/M137519 FROM : I H'I-CHLl<Q-I SANT" "lNR FAX NO. 714 552 e1~B Oc~. 12 2005 1121: 37Atl 1"2 ,ADDITIONAL INSIJRF~ ENDQRSF..MENT fOR COMMBIlCIAL G'E1'NF.RAL LlABIJ.ITV'l>()T Tey Illsu:anCe Company : The Ordinary Mutual. a R.R. G. C. This endorsemCJIt modifies such iDsUtanco as is afforded by the provisions of Policy 1/ CGAL0042005 relating to the following: 1. Tho City of San1a APa. 20 Civic Cemc:r Pbua, Sm>1a Ana. California 92701; its officm. emplO}'Q1lS, ageuts, V<I~ Brld zepreselJl8liVes ate IJl\lIIlld as addi1iollallDsureds ("additiowd iDlP......ls") with ~d to liability IlIt1 defense of Sl.lits arising from the opemtions and uses performed by or on behalf oftbe DaIDeCllnsured. 2. With >:espect to oJaims arising out oftbe operations and uses perl'mmiid by or on behalf of the 1WDed iI1sun:d. i1ICh iDsuraDce as is alfonled by this policy Is primaty IlIt1 is not additiODlll 10 or contrlbuling with allY other ~ canled by or for the benefit of the. additional insureds. ,3. This iDsuranc:e applies se.-.ady 10 each iD.smed agaiDsl whotn cJaim is mad.. or IlIIit is bn>ught mteepl with respect to the ~y's linuts ofliabi1ity. 1w. inclusion of any person or Ol'll....r...!jon as an insured shall not effect any ri~t which such person or organizatior. wollld have as a claimaslt i!not so included. 4. With re6l*t to the lIdditicmal insureds. thi~. i1lSUI'al1OlO shan not be cancelled, or materially teduced in COverll$C or limi1s except after thirty (30) days wriuenllDdce hu been given to the City of Santa ADa. 20 Civic Center Plaza.. ~ Ana. California 92701. (Completion of the following, including COIIIItcrSignature, i. requittAi In make this endorsement effccUve.) Effective Policy 1# Issued to July 1, 2005 CGAL0042005 The Roman Catholic Bishop of Orange, A Corporation Sole . 1his cndoDelnent futm as a part of Co\ll1tmigncd by " ,'!WV. ! '-',j;' , ..'/J;$ j!, ,_, , c' ,_,~J)' '_:d~i AUur:,cy E0. 39\1d 39N~~O 30 3S300ra 6~0E-Z;8~'I>!L Z;9:91 900~/0~/01 CCT.27'2005 14:42 #00,6 P.,02/004 .- " Rigl,t.FAX 10/2512005 11::10 PAGE 0021004 Fax Stlrver .... ft,,_ ---" '1112 ~C()RQ.. CERTIFICATE OF LIABILITY INSURANCE I """(IIIIIDDI'fVV'I '012812005 -- THIICEftTlflCATEI& ISIUW AlA Of INfO_TION ArIhuo' J. G"li~h... & Co. Ir1I!I. ONLY AtiD CON'!Il' NlllUlIHn UPON THE C!RTII'ICAT! HOlDER. T1tIG CIiIlTIPICATI DOl. NOT N11Il1P, &XTIlID OR 1iroker8 of OA inc Uc.II072IlUJ ALT!IlTHI!COY!ftAG!API'DI!.Dm BYTHEI'O~ BELOW. Onalll...laoIlI_ Twr lit. all San Francie.... CA 114106 IHSU_ Afl'OlllllNG COVERAllI1 NAJC' ..~ .NlUmJ ......"'., Tho Oldln.." M......L 0 R.R.G.C. 11171 _n Cathallc Blohop 01 Ol'llllP "'~IIIl', Unllld II.",. fldalllv o"~ Go.'''''''' 218.7 P,O. Ilox 14181l NlI..IRaC: Orang8, CA 02161 - ..1..Rftu, ..1JI1l.~ a~ COYERAOE8 l116POLIClU Of I'ISU~CI LIlTeD III!!..O'iV tvlve Bm.llH1.Il:DltI n1E nsUftED tw4ED ~ POR THl!POUCY PERtOP'NP~CoIITF.o. NQTWrr~AJ\DfNllI Nt( RfOlIftfUBfl'. YeRM Oft COf'lDTlON Of AJ('( CONTRACT QR 0THiR ~WIT" Plii6PIiiCT TO WHIQ,1 Ttfl CERnFIC:^TIi ""'... a~ fSSUED OR Wo'l" F1!!RT~. nP 8'4lIURANce APF'CIRDEDBY"TI'II:P'OLEIYDBSafU8EOHERflNIS SU8"IECTTOAU. THl!TYMS, !Xl.1..USONfi Ar'IgOONDlllONSOP,8UCH PDLlCIm.ACiGIa!GATE L1MIl5BHO'NN UAY HAVE 8EEN RBlUCEPBYI"A1D CLAIM!). Tn"lqflfllUItANCI NHJCIJ........ JI: CGAL'~ A PCUCI' "1ITI*OtI1Ui1.1A~,lTl' X UNAlI'l't1 ALL CWHtD^UTOB CGALGII4ZOD5 PAOIIlJCTS~~"~G 07/01/0' 07101/" CClNlltEl SINQl..E UUlT l~""'~ '1.DCl01100 eOBMJ~ Io.UTO~ IClDILYOOUIW t"ll~ . _0""",,, NDN-OWHE;D .wTOS ^ ::'7?..iJ j ..~..) ,- T(" C y~ Tvl A;:, . J J. .....~ ItClJILYlN.JUlIIY {rwtoti....oi} . AlITA"'" ""'.......,- 1....1ClCIIl.,q . OCM.....-l" ,. ~ tAAec 1, 'GO . m~ IICCUI,IU..kIiLLA LiAllnlJTY DOQJfl D O.AJ. WID!; AS~i.'6W,lt IfAQt QGGlMlISNCli , ~_. DIIlUCTlllO MTmmON i!I B WORKIM CCMi'IIIIA11M1.Ur1li IMPLmIftlr UAlW'T'I' lINt l"MClf'Wl""OI'W'AH;T\EAlEKEClJTlYE ~"'I!XI::W~1!Cf ~.l~lIP'dlIt .~.i-i;M.t.!M.IQNJ_ll;t:t~_. ,"'... D2ISW008" 11/19/04 ll1U/US . .' .1 000 DOD ,UO 00 ,1 001.000 aneQl'MNeJ'eJll.lU.ftmI./LeICIo'ftOMl/WllltIUII/IMiI:IUItIOlll""DIIl rt_M......iW/~..ItD\II1II~ lie: U_ DellIgh _0,,1. 1:l1l1 W.ot lIa..... A\/lInu., ..- Ana, c.t, 827117. M ....paeta 2005-2 ac_ V..... '.ooKy .. SIIIIf P81'1c1nl11ot on tItI COI'llll' of OTchord .. 1k1.1o~ "nta AM, CA from o:aOMn - 1:00p1lJ. CIty of lion'" Ano. Ita ofIIcwo, _loyoM. "IJonto, volunte_ ond ..pr...nbdlveo or. .......d.. "'dl~"",,lln5U..d pel tIlo .n_ _Imlnt. CElmFICA HOLDER City '" S.nt.. Ano vi" elt~ C.rk OffIee 2ll CIvic _ PlIO S'mli AmI. CA 12701 fJ"ClLlLOMff I;JfltCAeDYf. DEICIIDeD I"'QU'OIU ~ OAtIZLLaQ BEfiDRf nIi iX1'1\A11CtI gA1I.fHlMCI"1tIl.I&aIIU<<IINlWU!RWlu..I!.....Vllfl!ftJIMIL....34... bA'YII'MalTTIIN Nance 10 'fH1i CIiRllF1C41i ~ Nl.LIlD fO 11t1i LIPT.IlUTFAlLWll1D DD 10 1HAlJ. IMPCIII NOotLIIII"'nDtI Oft LII'l8ILnV or APrt WDaI-~QN'1'HIIfI.Uftljflo rtI ADM'" g" . A\mtONimO M.Iilf:MiMfUlVII ACORD &(301110111 uf 2 llS14414ll1M1JT,18 qCT.27'2005 14:42 .. .. #0006 P.003/004 RightFAX 10/28/2005 11 :30 PAGE 003/004 Fa.x Server IMPORTANT If ill. coriif...to held.r i. on ADDITIONAL INSURED, tho JlCIIcy(""'l mUll! be llndOrMll. A .tat."",nl on lhl. cerlirc:ale d_ nol _for rtQhlo to ,,. .orIin..te hGklor ill"'" of.""" endo,..mlll1l{s). If SUllROGA'nON IS WAIV~O. SllbJ8d to tho torm. and oondltlons 011110 policy. cerfoln policl.. may r"'lulro on ondoAe/l1ont. II _ment 011 INa _to do.. not 1XIflf., right> to 1110 ..rtIfIoat, ho\:l... ir't lieu of ItJeh t!lM~tlMimiilf'ltr*}. Dl8CLAllltEfl Tho C<lrllflcole of Insuronoo on tho rov_ old. of ll1l. form d_ not consUlullo . conlroct be-. the issuing l~r(.)r .utborlzlld J'8pI1IllirilltlV& or producar. and th. certtn~ t'wll4;l"1 nQr doll!l' I .mrm.!lvely 01' necllltlvoly lII'Ilolld. ..tend 0' olio, 1110 _..go """ftllId by Iho policItKi lI.rld Iher"".. ". ~ ,- ....1 !.'();\, I ~__~(3 " ".- _, l _1 ,_ ~;,.\.j) A:).)ijl<;~H City Allor:-.cy ~COllD ZN lZOOilOllI Z Of Z #l14t14DnM137'1t CCT.27'2005 14:42 , -. #0006 P.Ol4l004 Rig},tFAll J 0/2B/2005 11: 30 PAGE OOIl/OOil I'ax SATVAT , . FRCI1 : lI...au'~ $Roffil RNR _ NO, I 71. Si~ 01:'10 Cet.. 12 0EEr.li ~a~ ;;riAI'I P2 fOR~:,~,~~lrv ~ Com!llll1, : Th. Ordln.,V MUlulll, . R.R, G. C. .!>It cnoIDnameal:..,..utl..... ~. IlIIIIl aflimled b)' rb<> pl'O"i!llQu oll'<>&y ill. CGAL~2OOIi 1daItD~ 111 lIlo:ll>liowlQ: 1. 'TIuo ClIJ Dra......... all QYID ~'" ~ Soua Ana. CaIlfDtIiOl W.70111ll oIIInd, _pI )IMll1I........ y-'L 1~1Dd...... .~:n olDled u addlUcIaal bIMnIf (".&llI!- iIIIIIIIell&.) v1t1n.ulll> 1i6lIIl!Ir 11I4 lit.... qf'51llIr odslnc &om .... ....... lIIIll..... podl""",,, br 0'_ WloI:f of_1IeIll6ll m.-I. . a. WlIh................0Iia....<>fIlso(ll"""""""1IIlIiU..h. ,,""b)'0l0ll llolmIfotdllolllmld iIIIured, noII_ ulI __ b)'dds pollql.poLaa>:)'_101ld: lldditlaol 10 or .",,1I'IbotII>a wI!l1 iItjI oIbIr ~ 4:IlIrlod by 0: .lbr1he bcnofil of1h... ..Jdil:Io1IOllDlwoedt. ,1. Th!$ ;."--1NIIeI ~J'll.l- iallUlWl.r;oln&lomoa oIIlmls....ae.. .1Ilt \o~.... 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CERTIFICATE OF LIABILITY INSURANCE lOA.......,..,.,.." 1ll/2t112DO!l - 1111 CER'II'lCATE I8I881J!D AS A IIATl1!Il OP INP_TION ArthUr J. G1d11Qlllr & Co. 1M. ONLY AND CONPERI NO RIGHTS UPON THE CERnFlCIlTE ......... of CA Inc Llc.lIlI728283 HOUlEIl. 1111 CliRT11'1CATE DOlI NOT AM&MD, &XT!ND OR ALTER THl! COV!RAGIAI'POROED BY THE POUCIE8 BELOW. One III1l11t ape. Twr .. 200 SlIn FnmcI_ CA 841a5 118U_ Al'l'0RDIIG COYI!RAGE NAlC. ...- NdmknwO~MWII"~a~~~~ 10171 Rom.. Catholic BIIhop of Ora. IN8l.l\m., UIIbd ..... FI one! Bu_ 21887 P.O. Box 141. ".......0 Ora.... CA 82181 -'" "lNRE= COY!IWlEI8 1lt! PDUCII!B Of INBUIWlCE LJm!D III.OW HAVI! I!I!I!N ElIUBlTO 1lt! tl8UREIlNolMBl MYNE FOR THE PllUCY PliOOD IfOCI\TED. NOTWITHSTANDING 1M'f1ll!ll1l_, TEllU Oft CONDITION OF "'" CONTJW:T OR D1lt!R IlOClI.tENTYoITH IlEBPEer TO WIIa< THIS CERl'IFlCATl! MAY BE ISSUIil OR MAY PMTAIN. THI! __CO! APFllRIlED BYTfE POUCIEB _CAlBED _lSaUB.ECTTOAlL THE T_ EXCWlIION8 AND CDNcmoNSOf.SUCH POUClIlS.AGGIlI!GAT1! 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I1li ofIIcara, ...p1oys... aganls, 1IOIuIIte8!8 and .......anlatlvas are namad .. addl_a1 .......... por 1M aIl8chad llIldor88manL C TE LDER ILI.ATlON 8tIOI&DNIt( crTtE1lIO'I1 DUCRIIII!I) POUClIIBeCAIICIILLID.-.oM M IXP'W.lJJfI DAlIftI....,....I._INIUftIR'MLL~TOML --3L DAYliWRmB NCmCI10TtE ClIU"JFlC\Ti HDUJIR IIWEl TO ntllJIlT, BUT PAlLtMlTO DOIQItlALL "P~ NO OII.DATlDII ORLIUItJIY OF IIN aml.Rtll1l41i.....ftIf\ '" _m ~ - AUlHClRlZlDRI!....NTA1IVI en, of Santa Ana c/o City Clark OlIlctl 20 Cl'llc C_ P188 Santa Ana, CA 12701 . t.CORD IIIl1D1'1.) 1 of 2 18144140111137!118 RightFAX 10/26/2005 11:32 PAGE 003/0011 Fax Server IMPORTANT If the oerIIflcole hdder Is III'l ADDITiONAl INSURED, tile poItcy(lBo) mlJllt be endorsed. A statement on this cerlllale doeo not conh, rtghls \0 the certlftcR holdlll'ln I"'" of such endorIement(8). If SUBROGATION IS W~, 8UbjeC\ \0 Ihlltenn8and oondll1on8oflhepollcy,cortlIi1 poIlc1e8 may require en endonIement. A ....men! on this cerIltlcItll daM not oonfor rlghlB to the oerIIflcaIe hoklor In leu of such endo.-nenl(.). DISCLAIMER The CerlllIcaIe of 11l1urance on the _lIIde of this form doeo not COIlIIlIIule 8 conIracl belwelll'l \he IuuIng 1nlIurer(1), authollz8d rep_rIalIYe or producer, and \he cerlIIIcate holder, nor doIs I affirmatively or negatively amend, 8ldlllld or BIer tha coverllg& III!ORIod by the poIlc1e8ll8l8d thareon. ACORIl_ (2011/11) 2 of 2 181441401M13751. RightFAX 10/26/2005 11:32 PAGE 004/004 Fax Server . I'RCII1 , IfI'loOt..llOl SRH1l'I RiA _1-0. :?l.4~1I1;;;l 0.... 12 0IlI0l> 1111 J7Ai'1 1'2 b!>.............l INItlRIm IlNDORmlUl'~T ~ fnR~-~t~~4T ,'''U11.ITV1WV~ 1IlIUl8IICO COIIlIIlDlY : Tho Ordinary Mutuel, e R.R. G, C, TIIIt ..,Q..__mocIIIiClo1Il11lb ~ Ills ...... by -pvviIlOIlS oll'clUc:y fI, CGAlOO42006 ftiat\1lIlO b flIIIow\lII: 1. the Cllifd:IledaI\lla,:lIlCivlo c- Pl8iIa. ScaAA ""I...... 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(CllaIp1oIhmoflha tbIJow!Qa, ..rh..U.__olao'-", ill ~ tD....1IlIt ...s...___ dfeo\tYe.) , .' Po1la1* !IIuocI1lI July 1, 2005 .1llis CIIld~lba...taptl'lo! CGALOO42005 Tho Romon CaIhoIc Bishop of O"mgo. A CoqJOl1JtIon Sole Dutl,"9 Eo 39\1d ~ ,[) 3S3OOIa &taE-t~-~tL tg:91 9BSt/ot/8t RightFAX 10/26/2005 11:32 PAGE 001/004 Fax Server . ARTHUR J. GALLAGHER RISK MANAGEMENT SERVICES . ARTHUR J. GALLAGHER INSURANCE BROKERS OF CALIFORNIA, INC. One Market St, Spear Tower - Suite 200, San Francisco, CA 94105 CA License #0726293 Facsimile Transmission From: Name: Fax Number: Voice Phone Raquel Reyes-ReyalBSD/AJG 415-536-8499 415.546,9300 To: Name: Company: Fax Number: Voice Phone Pat Jaquez City of Santa Ana 714.647.6956 Fax Notes: Date and time of transmission: 10/26/2005 11 :27:48 AM Number of pages including this cover sheet: 4 A network (ax _ CommUllicaled Documellt