1993-0907_ORANGE COUNTY HEAD START_Insurance Certificate (Commercial 8-25-98) ACORDM CERTIFICAM c OF LIABILITY INSURAi' E DATE(MM/97 09/12
Y)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Caldwell Ins.Agency Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
15935 Whittier Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Whittier, CA 90603-2567 COMPANIES AFFORDING COVERAGE
COMPANY
A Great American Ins Co.
INSURED COMPANY
Orange County Head Start, Inc B
Attn: Ted Fisher COMPANY
1440 E First Street c
Santa Ana, CA 92701
COMPANY
BOH D
COVERAGES
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THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
COTYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE(MM/DD/YY) DATE(MM/DD/YY)
A GENERAL LIABILITY PAC2000372 08/25/97 08/25/98 GENERAL AGGREGATE $ 2,000,000
X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 1,000,000
CLAIMS MADE X OCCUR PERSONAL&ADV INJURY $ 1,000,000
OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE(Any one fire) $ 200,000
MED EXP(Any one person) $ 5,000
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $
ANY AUTO
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:f4
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND WC STATUS I ER
TORY LIMITS I ER
EMPLOYERS'LIABILITY
EL EACH ACCIDENT
THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $
OTHER
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DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
Certificate holder is added as additional insured with respects to premises o r, — c,
leased to named insured at,32502 Paseo Adelanto,San Juan Capistrano,CA r^h ,`., rn
1T---–f'" -v
CERTIFICATE HOLDER CANCELLATION:Ten Day Notice for No ='agmen o e t'„
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEtra BEFORE THE
City Of San Juan Capistrano EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
32400 Paseo Adelanto 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
San Juan Capistrano,CA 92675 B FAILURE TO MAIL SUCH NOTICE HALL IMPOSE NO OBLIGATION OR LIABILITY
OF A Y KIND UP THE P NY, ITS AGENTS OR REPRESENTATIVES.
AU •, D INEPR EN TIVE
ACORD 25-S(1/95) O ACORD RPORATION 1988