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,te,,4/16/2004 Time, 10,01 AM To: Thompkir- Carla 0 1-714-647-6549 Page: 002-011 ACOPQ CERTIFICATE uF LIABILITY INSURANCc DATE (MMIDOIYIYI') rl 04/16/2004 PRODUCER (310) 393-9477 FAX (310) 393-7186 White & Company Insurance Inc P O Box 70 Santa Monica, CA 90406-0070 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 I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Daren O'Neill INSURERS AFFORDING COVERAGE j NAIC# INSURED Women' s Transition Living Center PO BOX 6103 INSURER A'. Philadelphia Ins Co INSURER 4_ Orange, CA 92863 NSURERC NSURER D: --1---------- - NSURERE. _ -- - - 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. INSR ADOI HE TYPE OF INSURANCE POLNYMlABER POLICY EFFECTIVE DATE POLICY EXPIRATION DATE LIMITS EACH OCCURRENCE 1 1 OOO GENERAL LIABILITY PHPK076921 04/04/2004 O4/04/2005 COMMERCIAL GENERAL LIABILITY DAMAGE TOR NTED 100, OW CLAIMS MADE ❑ OCCUR MEDEKP(Arryoneperson) 1 10 ,000 A PERSONAL x ADV INJURI 1,000,0 GENERAL AGGREGATE '6 2,000,000 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOPAGC- _ _ 1 2, 000 POLICY JECT"' LOC —� ---- AUTO MOBILE LIABILITY PHPK076921 04/04/2004 04/04/2005 COMBINED SINGLE LIMIT IPAacOtleM) 1 X ANYAUTO 1,000, 000 BODILY Y UJPY - - - ALL OWNED AUTOS A SCHEDULED AUTOS (Pe,persm) 1 - HIRED AUTOS BODILYINJURY T N'ONLOWNED AUTOS (Per acriaeM) PROPERTY DAMAGE I (Perac itlenr) GARAGE LIABILITY AUTO ONLY- EA ACCIDENT S ANYAUTO HAN EA ACC 1 AUTOO AUTO ONLY AGG 3_-- EXCESSILMBRELLALIABLITY PHUB029035 O4/04/2004 O4/04/2005 EACH OCCURRENCE 1 2.000.0001 X OCCUR CLAIMS MADE AGGREGATE 1 2,00 0, A - -- 1 DEDUCTIBLE -I 8 I RETENTION S i WORKERS COMPENSATION AND I' ° - WC STATU OTH EMPLOYERS'LNBILRY TORYLIMITS ER EL. EACH ACCIDENT 1 ANIYPROPRETORIPARTNEREXECUOVE OFFICERIEMBER EXCLUDED? / E.L. DISEASEEAEMPLOYEE P tt Ses, Oescnbem @, E L. DISEASE - POLNJY LIMB 8 SPECIAL PROVISIONS below OTHER t DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS ity of Santa Ana, its officers, agents, employees, and volunteers are additional insureds as per fo I-NP-003 (05/01) Item M - Funding Source and Primary Insurance as per form CGOO 01 07 98, both attached to the general liability policy and accompanying this certificate. *Except for 10 days Written notice of cancellation for non-payment of premium. IS CERTIFICATE SUPERSEDES & CORRECTS PRIOR CERTIFICATE ISSUED 4/13/04 TO THIS CERTIFICATE HOLDER. i City of Santa Ana - CDBG M-25 Attn: Carla Thompkins P.O. Box 1988 M-25 Santa An, CA 92702 ACORD25(2o01/o8) FAX: (714)647-6549 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL 1N5YM)()06WL 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, IDDEIfD(1�IYxvw-vwjwyxmxyxow 4KDHOC?(1fd"XxwotXXXXX AUDIORRED OACORD CORPORATION 1988