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ACaRD,, CERTIFICATF lF LIABILITY INSURAN'' DATE 04/13/D2005) <br />04/13/2005 <br />PRODUCER (310)393-9477 FAX (31.,,393-7186 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />White & Company Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />P 0 Box 70 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW <br />Santa Monica, CA 90406-0070 <br />INSURED Women Transitional Living <br />PO Box 6103 <br />Orange, CA 92863 <br />COVERAGES <br />INSURERS AFFORDING COVERAGE <br />INSURERA: Philadelphia Ins Co <br />INSURER B. <br />INSURER C. <br />INSURER D: <br />INSURER E: <br />NAIC # <br />•� n„vt OLEN Ibsutu 1 U I HE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENTTERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />INSR <br />INSREADD1 <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE aiM/nUDYj <br />04/04/2005 <br />POLICY EXPIRATION <br />DATE IMWDDM) <br />04/04/2006 <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADEff] OCCUR <br />PHPKI15560 <br />EACHOCCURRENCE <br />E 1,000,00 <br />DAMAGE TO RENTED <br />PROMISES E, door rosaiDIED <br />b 100, OO <br />EXP (Any one person) <br />$ 5,00( <br />PERSONAL & ADV INJURY <br />$ 1 , OOO, 0O <br />_ <br />GENERAL AGGREGATE <br />$ 2,000,00( <br />SENT AGGREGATE LIMIT APPLIES PER: <br />POLICY1-1 PROT LOC <br />JEC <br />PROWCTS- COMPIOP AGG <br />$ 1,000,00 <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOS <br />PHPKI15560 <br />04/04/2005 <br />04/04/2006 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ 1, OOO, OO <br />X <br />SCHEDULED AUTOS <br />BODILY person) <br />$ <br />HIRED AUTOS <br />NONOWNEDAUTOS <br />I BODILY O B <br />DINJURY <br />LY N <br />$ <br />PROPERTY DAMAGE <br />(Peracadenry <br />$ <br />--' <br />GARAGE LIABILITY <br />AUTOONLY-EAACCIDENT <br />$ <br />ANY AUTO <br />OTHERTHAN EA ACC <br />AUTO ONLY: AGO <br />$ <br />$ <br />A <br />EXCESS/UMBRELLA LIABILITY <br />X J OCCUR ❑ CLAIMS MADE <br />PHUB043582 <br />O4/04/2005 <br />64/04/2006 <br />EACHOCCURRENCE <br />$ 2,000,00 10 <br />AGGREGATE <br />$ 2,000,000 <br />a <br />DEDUCTIBLE <br />E <br />RETENTION $ <br />$ <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />WC STATU- OTH- <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETORIPARTNEWEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />E.L. DISEASE - EA EMPLOYE <br />$ <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />1 <br />aura Stitt She <br />dY <br />EL. DISEASE -POLICY LIMIT <br />$ <br />OTHER <br />ASS <br />Stant CitY Aft <br />rUdV <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED By ENDORSEMENT / SPECIAL PROVISIONS <br />.ity of Santa Ana, its officers, agents, employees, and volunteers are additional insureds as per form <br />'I-NP-003 (05/01) Item M - Funding Source and Primary Insurance as per form CGOO 01 07 98, both <br />ttached to the general liability policy and accompanying this certificate. <br />"Except for 10 days written notice of cancellation for non-payment of premium. <br />City of Santa Ana - CDBG M-25 <br />Attn: Frank Hernandez <br />P.O. Box 1988 M-25 <br />Santa Ana, CA 92702 <br />4CORD 25 (2001/08) FAX: (714)647-6549 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL NXXXNi(d6d6 MAIL <br />30" DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />WVOWXMXIUWA)LU)(KKWOMXXXMMKXd(XLXMU)bXXKXMXXX <br />AUTHORIZED REPRESENTATIVE <br />hleen <br />B <br />©ACORD CORPORATION 1988 <br />