1993-0907_ORANGE COUNTY HEAD START_Insurance Certificate (General & Auto) AcoRRRI CERTIFICATE` INSURANCE ISSUE DATE(MM/DD/YY)
9/30/94
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
Markel Rhulen Underwriters & Brokers EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
4600 Cox Road
Glen Allen, Virginia 23060-9817 COMPANIES AFFORDING COVERAGE
COMPANY
CODE SUB-CODE LETTER A Insurance Company of Evanston
COMPANY B
INSURED LETTER
Orange County Headstart, Inc. COMPANY C
1440 E. First Street, Suite 320 LETTER
Santa Ana, CA 92701 COMPANY
D
LETTER
COMPANY E
LETTER
COVERAGES
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
)AID CI AIMS.
CO POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER LIMITS
DATE IMM/DD/YY) DATE IMM/DD/YY)
GENERAL LIABILITY GENERAL AGGREGATE 8 2,000,000
A
X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OPS AGGREGATE $ 1,000,000
CLAIMS MADE X OCCUR. 8502CY003098-0 08-25-1994 08-25-1995 PERSONAL&ADVERTISING INJURY $ 1,000,000
OWNERS&CONTRACTOR'S PROT. EACH OCCURRENCE $ 1,000,000
—
FIRE DAMAGE(Any one fire) $ 50,000
MEDICAL EXPENSE(Any one person) 8 5,000
A AUTOMOBILE LIABILITY COMBINED SINGLE
$
ANY AUTO LIMIT
—
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per Person) $
X HIRED AUTOS 8502CY003098-0 08-25-1994 08-25-1995 BODILY INJURY
$
X NON-OWNED AUTOS (Per accident)
GARAGE LIABILITY
PROPERTY DAMAGE $
EXCESS LIABILITY EACH OCCURRENCE 8
UMBRELLA FORM AGGREGATE 8
OTHER THAN UMBRELLA FORM
STATUTORY LIMITS
WORKER'S COMPENSATION
EACH ACCIDENT $
AND
DISEASE-POLICY LIMIT $
EMPLOYERS'LIABILITY
DISEASE-EACH EMPLOYEE $
C79
A OTHER C-�
Property 8502CY003098-0 08-25-1994 08-25-1995 ^� or) ._ 7)
_. +r.--< C,
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS .1 t:'1.N n v....., m
fir- N :<
–
Certificate holder is included as additional insured as lessor of premises. t Z z n m
r_ -1r
CE14TIFICATE }BLEIER.: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
City of San Juan Capistrano MAIL 15 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO
32400 Paso A Delanto THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION
San Juan Capistrano, CA 92675 OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Bruce A. Kay ;f' �/ ,
ACORD 25-S(7/90I tcJ A QH C ...:'•110N..19.90