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ACORv CERTIFICAT- OF !ABILITY INSURAW l OP ID J DATE(MWDDNYYY) 1E PRODUCER - Chapman & Associates License #0522024 P. O. Box 5455 Pasadena CA 91117-04$5 , DAY 1- 05/28/04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone: 626-405-8031 Pax:626-405-0585 INSURERS AFFORDING COVERAGE NAIC# INSURED DATE M INSURER A: iiveryorc ivaurane� Cevpany INSURER B: X GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLA7AS MAGE X❑OCCUR X Professional Llab Dayle McIntosh Center 13272 Garden Grove Bl. Garden Grove CA 92843 05/25/04 INSURER C' INSURER D: INSURER E: PREMISES Ea occurence) E $0000 r-nVFRAGFS: $5000 PERSONAL S ADV INJURY THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRWnI TYPE bF INSURANCE POLICY NUMBER DATE MMID DATE M LIMITS A X GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLA7AS MAGE X❑OCCUR X Professional Llab RP0004983 05/25/04 05/2$/0$ EACH OCCURRENCE $lOOOOOO PREMISES Ea occurence) E $0000 MED EXP (Any one Person) $5000 PERSONAL S ADV INJURY $1000000 GENERAL AGGREGATE $ 3000000 GENL AGGREGATE LIMIT APPLIES PER: POLICY PRO - JECT Loc PRODUCTS -COMWOP ADD $ 3000000 Ben. INCLUDED AUTOMOBILE LIABILITY A X ANY AUTO RP0004983 05/25/04 05/25/05 COMBINED SINGLE LIMIT (Ea acddenl) $lOOOOOO ALL OWNED AUTOS SCHEDULEDAUTOS BODILY INJURY (Per person) E X HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) E PROPERTY DAMAGE (Per accident) E ' GARAGE L"ILITY AUTO E- !ACCIDENT OTHER THAN EA ACC AUTO ONLY: ADD E f ACLAIMSMADE t�CESSAJMBREL�nLIABIIJTY RPX004984 0$/25/03 0$/2$/04 EACH OCCURRENCE $lOOOOOO AGGREGATE $1000000 E $10000 E COMPENSATION AND EMPLOYWORKERS EMPLOYERS' LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTNE OFFICERIMEMBER EXCLUDED? E.L. EACH ACCIDENT E Ryes, describe under SPECIAL PROVISIONS below E.L. DISEASE - EA EMPLOYE $ OTHER E. L. DISEASE - POLICY LIMB $ A Sexual Abuse Liab RP0004983 05/25/04 05/25/05 Ins Limit Included DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BV ENDORSEMENT I SPECIAL PROVISIONS The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and representatives are named as additional insureds with respect to the operations of the named insured. CERTIFICATE HOLDER SANTAA4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Santa Ana NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Community Development Agency IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. BOX 1988 REPRESENTATIVES. Santa Ana CA 92702-1988 AUT EO REPRES ATIVE 25 (2001/08) (C) ACORD CORPORATION 1988 Q