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DATE (MM DDYY) -/aCOPD CERTIFICAT[ X LIABILITY INSURANL _ OP ID $ WISEPLI 12 24 03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Advanced Insurance Marketing HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 4459 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Orange CA 92863-4459 Phone:714-997-8100 I INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA'. Philadelphia Indemnity ins Co. INSURER B'. Wiseplace, a Ca Corp INSURER C: 1411 N. Broadway INSURER D:---" Santa Ana CA 92706 _..._- INSURER E 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 UAV 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. SRC POL�FECTIVE POi EXPIRAT16N� LTR INSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDDM DATE MWOOIYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE LX� OCCUR PHPK068383 O1/Ol/04 I 01/01/05 i EACH OCCURRENCE $ 1,000,000 rOnIIAGO A PREMISEFES (Ea occurence) $100,000 MED EXP (Any one person) If 5,000 PER'SONAL&ADV INJURY $ 1, 000, 000 — — GENERAL AGGREGATE $ 2, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER'. POLICY PRO- JECT 7 CDC PRODUCTS - COMPIOP AGO $2,000,000 _ AUTOMOBILE LIABILITY A ANVAUTD PHPK068383 01/01/04 O1/O1/OS COMBINED SINGLE LIMIT (Ea accident) $ X ALL OWNED AUTOS —" SCHEDULEDAUTOS Y ODIL NJ Y INJURY NJ BODIL $ 1, 000, 000 HIRED AUTOS — NON -OWNED AUTOS - BODILY INJURY IN (Per accideBODILY S PROPERTY DAMAGE (Peraccident) $ GARAGE LIABILITY ANY AUTO '- J- I " - - AUTOONLY-EAACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG S I A EXCESSIUMBRELLA LIABILITY X OCCUR CLAIMS MADE PHUB025638 01/01/04 01/01/05 EACH OCCURRENCE $ 1, 000, 000 AGGREGATE $1, 000, 000 $ DEDUCTIBLE $ —"--- X RETENTION $1Q, QQQ S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORV LIMITS ER E.L. EACH ACCIDENT S ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ if ye- dssn ot, under SPECIAL PROVISIONS below E.L. DISEASE POLICY LIMIT $ OTHER I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Ten Day Notice of Cancellation for non-payment/non-reporting/ The City of Santa Ana, it's officers. agents, employees, and volunteers are named as additional insured per attached Additional Insured Endorsement. RE: Insured received (HUD) Community Development Block Grant Funding & Emergency Shelter Grant Funding to support their shelter program for homeless women. CERTIFICATE HOLDER CANCELLATION SANTAAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE "Ie'"TIO DATE THEREOF, THE ISSUING INSURER WILL_ MAIL 30 DAYS WRITTEN CITY OF SANTA ANC COMMUNITY DEVELOPMENT AGENCY M-25 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, MICHAEL GARCIA P.O. BOX 1986 S. SANTA ANA CA 92702-1988 AUTHO ATIVE (2001/08)