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CERTIFICATE I" INSURANCE lions 003E PRODUCER Ce05382 HOLBERT INSURANCE AGENCY P.O. BOX 1208 SAN CLEMENTE, CA 92674-1208 (949) 492-6138 FAX (949) 361-4079 WOMEN HELPING WOMEN 711 W. 17TH STREET, #A-10 COSTA MESA, CA 92627 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND =ERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE i NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE CIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A TRAVELERS INDEMNITY CO OF IL COMPANY B COMPANY C 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. O TR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MMIDD/W) POLICY EXPIRATION DATE(MM/DD/YY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY LINS MADE OCCUR. X OWNER'S B CONTRACTOR'S PROT. 680-466P105-A OCT 28 03 OCT 28 04 GENERAL AGGREGATE E 2,000,000 PRODUCTS-COMP/OP AGO. E 2,000,000 PERSONAL B ADV INJURY E 1,000,000 EACH OCCURRENCE E 1,000,000 FIRE DAMAGE(Any One Fire) E 300,000 MED. EXPENSE(Any One Person E 5,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 680466P105-A OCT 28 03 OCT 28 04 COMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per Person) E X X BODILY INJURY (Per Accident) E PROPERTY DAMAGE E GARAGE LIABILITY ANY AUTO RL - La :Li .�." / 1*,�� �'�� Nd. AUTO ONLY - EA ACCIDENT E OTHER THAN AUTO ONLY: EACHACCIDENT E AGGREGATE E EXCESS LIABILITY UMBRELLA FORM _OTHER THAN UMBRELLA FORM Ass ""'"' Staut 1 3 "ttOT 10)T EACH OCCURRENCE E AGGREGATE S WORKER'S COMPENSATION AND EMPLOYERS'LIABILITY THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERSARE: EXCL STATUTORY LIMITS EACH ACCIDENT E DISEASE -POLICY LIMIT E DISEASE -EACH EMPLOYEE E OTHER DESCHIP I IUN Uh UFt"I IV NYLUGAl1UNJ/VGNM1:LtYJYtG WL I I tM3 OPERATIONS OF THE NAMED INSURED LCERTIFICATE HOLDER AS ADDITIONAL INSURED CANCELLATION CITY OF SANTA ANA, M-25 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL MAIL W DAYS COMMUNITY DEVELOPMENT AGENCY WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. PO BOX 2988 M-25 SANTA ANA, CA 92702 I 110-DAY NOTICE OF CANCELLATION APPLIES FOR NON-PAYMENT OF PREMIUM "Dqd-