1993-0907_ORANGE COUNTY HEAD START_Insurance Certificate (Commercial 8-25-94) . ............................... :...r.....r..r...n.:r.»r.:....r....r rr.u..r..:v:r:.::y,l+:n:?:iY4i'.i:•:::ii:v:. {::•�:h;+f++ ...:.//
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PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
Caldwell Ins.Agency Inc DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
�' y POLICIES BELOW.
501 S Cypress St
La Habra, CA 90631-9305 COMPANIES AFFORDING COVERAGE
LETT
COMPEANR Y A Western Heritage Inc.
BOH
COMPANY B
INSURED LETTER
Orange County Head Start, Inc LETTERCOMPANY C
Attn: Ted Fisher
1440 E First Street Ste.#320 COMPANY D
LETTER
Santa Ana, CA 92701
COMPANY E
LETTER
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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.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MM/DD/YY) DATE(MM/DD/YY)
GENERAL LIABILITY GENERAL AGGREGATE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $ 1,000,000
A CLAIMS MADE X OCCUR. 93CI,P0162076 08/25/93 08/25/94 PERSONAL &ADV.INJURY $ 1,000,000
OWNERS & CONTRACTORS PROT EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE (Any one fire) $ 100,000
MED.EXPENSE(Any one person) $
AUTOMOBILE LIABILITY
COMBINED SINGLE $
ANY AUTO LIMIT
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (PerPerson)
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS (Per accident)
GARAGE UABILITY
PROPERTY DAMAGE $
EXCESS LIABILITY EACH OCCURRENCE $
AGGREGATE $
............. ...................................................................
.............. .................................................... ................
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION I STATUTORY LIMITS
EACH ACCIDENT $
AND
DISEASE—POLICY LIMIT $
EMPLOYERS' LIABILITY
DISEASE—EACH EMPLOYEE $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
This certificate supercedes the onse issued on 8/25/93
Certificate holder is added as additional insured with respects to leased
premises to named insured
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City Of San Juan iiii EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
Capistrano MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
32400 Paseo Adelanto FT, C T FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
San Juan Capistrano, CA 92675 `: LIABILI OF ANY KIND SParTHE CO, •ANY, ITS AGENTS OR RE•RESENTATIVES.
...O.Pf i I 3:: AU •••• PAL.. PRES'IT• E
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-ISSUE•DATE•�MM�DDL •,••••••••
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08/25/93
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
Caldwell Ins.A enC InC DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
g y POLICIES BELOW.
501 S Cypress St
La Habra, CA 90631-9305 COMPANIES AFFORDING COVERAGE
LETTER A Western Heritage Inc.
BOH
COMPANY B '
INSURED LETTERCO �)
rV
Orange County Head Start,Inc LE RNY C
Attn: Ted Fisher
1440 E First Street Ste.#320 COMPANY D -- m
LETTER
Santa Ana, CA 92701
COMPANY
LETTER X�
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.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MM/DD/YY) DATE(MM/DD/YY)
GENERAL LIABILITY GENERAL AGGREGATE I$ 1,000,000
X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG.J$ 1,000,000
A CLAIMS MADE X OCCUR. CLP0137898 08/25/93 08/25/94 PERSONAL &ADV.INJURY $ 1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000
X Personal IRI �7'U FIRE DAMAGE (Any one fire) $ 100,000
MED.EXPENSE(Any one pension) $
AUTOMOBILE UABILITY
COMBINED SINGLE $
ANY AUTO LIMIT
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS (Per accident)
GARAGE UABILITY
PROPERTY DAMAGE $
EXCESS LIABILITY EACH OCCURRENCE $
AGGREGATE $
........................................................................................
......................................................................................
OTHER THAN UMBRELLA FORM
STATUTORY LiMITS
WORKER'S COMPENSATION
EACH ACCIDENT $
AND
DISEASE—POLICY LIMIT $
EMPLOYERS' LIABILITY
DISEASE—EACH EMPLOYEE $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Certificate holder is added as additional insured with respects to
premises leased to named insured.
gIItcYffI«.:#191.1gR.;.;:::;:.;:.;:.;:.;:.;:<.;:.:<.;:.:.;:.:<.;:.;:.;:.;:.;:.;:.;:.;:.;:.;:.;.;:.;:<.;:.;:.;:.;:.;:.;:.;:.;:.;:.;:.;:.;:.;:.::.:CRtCPt:A' N..:..Adi.B >. ::::::::::..:::.::::::::::::::.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City Of San Juan EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
Capistrano » MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
32400 Paseo Adelanto > LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE/NO OBLIGATION OR
San Juan Capistrano, CA 92675 IABI TY OF ANY KIND UPON HE COMPANY, ITS AGENTS eR REPRESENTATIVES.
AUT IZED R='RE` TAT
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