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AC-ORD. CERTIFICATE OF LIABILITY INSURANCE OP ID E DATE IMMIDD/YYYY) RooucER HUMAOPl 09 26 05 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Advanced Insurance Marketing ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 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 INSURERS AFFORDING COVERAGE NAIC0 INSURED q-?oo5-ore-oi� INSURER A: Phil Pdelphiw Srd.ity in. Co. - INSURER B: Human OPpk Brenda _ ddic Riddick 5540-A Trabuco Road INSURER C: INSURER D: Irvine CA 92620 INSURER E: _ rnvvowr_ec 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, INS U_ LTR1NS`RE TYPE OF INSURANCE POLICY NUMBER DATEIMMIDDIYYI DATE IMMIDD/YY LIMITS �GENERAL LIABILITY EACH OCCURRENCE 51,000,000 A COMMERCIALGENERALLIABILITY PHPK094958 09/23/05 09/23/06 PREMISES(Eaoccurence) S100,000 CLAIM$MADE OCCUR MEDEXP(Anyoneperson) $ 51000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 1 , 000 , 000 POLICY PRO JECT OC Em Ben. 1,000,000 AUTOMOBILE LIABILITY A ANY AUTO PHPK094958 09/23/05 09/23/06 CO BINEDq (Eaacd ent) LE LIMIT $ 1000000 ALL OWNED AUTOS '1 I BODILY INJURY - I SCHEDULED AUTOS (Per person) $ $ HIRED AUTOS - K NON -OWNED AUTOS BODILY INJURY (Per LYIN $ PROPERTY DAMAGE $ (Per acdaent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC --- - $ AUTO ONLY: AGO $ A EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE �I, EACH OCCURRENCE $ 4 , 000 , 000 AGGREGATE $4,000,000 PHIIB051971 09/23/05 09/23/06 $ DEDUCTIBLE APPROVtri L) J TO FORM$ — $ ][ RETENTION $10 000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY q� TWU LIMITS IN E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNEWEXECUTIVE /- tX� ZZ OFFICERIMEMBER EXCLUDED? Laura i Y SLi edy E.L. DISEASE -EA EMPLOYEE $ If es.desObeunder E. L. DISEASE -POLICY LIMIT '.E SP ECIAL PROVISIONS below /'.1519C!!.lC L,1 Y ACIOI'sc,\' OTHER A Social Service PHPK094958 09/23/0 09/23/06 Aggregate $2,000,000 5T Professional Liab. Occur. $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT ISPECIAL PROVISIONS 10 Day Notice of Cancellation for non-payment of premium. Certificate Holder, City of Santa Ana, its officers, agents, employees, representatives, and volunteers are named as additional insured per form CG2026. CORFAMI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Corbin Family and Community Center DATE THEREOF, THE ISSUING INSURER WILL lIIYWIYft" MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,-"'-"_. Rosa Alvarez OR $88 W. Santa Ana Blvd, 2nd flr '---- ----- Santa Ana CA 92702 AUTHO E ATIVE W AGORD GORPORATION 1988