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_ .AC!)f1D. CERTIFICA' OF LIABILITY INSURJ ;E I OATE~ ,. no 04/11/2006 PRO( ~)CER (310)393-9477 FAX (310)393-7186 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION White lit Company Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR POBox 70 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELPW, Santa Monica, CA 90406-0070 INSURERS AFFORDING COVERAGE NAIC # ""UIlED WOmen's Transit10nal LlVing Center IHSURER A:. Philadelphia Ins Co PO Box 6103 INSURER B: Orange, CA 92863 INSURER c: INSURER 0: lNSURER E: cnVl'RAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING Nf"( REQUIREMENT, TERM OR COIlDlTlON OF AN"( CONTRACT OR OTHER DOCUMENr WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE 'NSURANCE AFFORDED BY THE POUClES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDrTlQNS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ~ TYPE OF INSURANCE POLICY NUIIIlER POUCY EfFECTIYE POUCY EXPIRA110N LIIIIlS GENERAL l...IABIU1Y PllPk164779 04/04/2006 04/04/2007 EACH OCCURRENCE S 1,000,000 -,.,- X COtJNERCIAl GENERAL lIABUTY OAMAGI: 1?c~ENTED S 300,000 I ClAAOS IAADE 00 OCCUR MED EXP (AnY onit peISOn) s 15,000 A "PERSOrw: & 1DVlNJURY . 1 000:000 - GENERAl AGGREGATE S 2 000,000 - pRODUCTS - COMPlOP AGG 1,000,000 GEl'lL AGGREGATE LIMIT APAS PER: . 1 POliCY n ~ lOG !-UTOMOIlILE UAIllUTY PllPKl64779 04/04/2006 04/04/2007 COMBINED SINGlE LIMIT (Eaaccident) . 1 000.000 _ NfY AUTO AlL OWNED AUTOS BODILY INJURY X (Per person) S A X SCHEDULED AUTOS HIRED AUTOS BODILY INJURY -X (Per aeddeol) . f-'-'- NON-DWNED AUTOS PROPERTY DAMAGE S (Peraccidenl) R;~ AUTO ONLY - EA ACCIDENT . OTHER ~ EA ACe S AUTO ONl. Y: AGG S EXCESStUMBRELlA UABIl.ITY PIftlB061149 04/04/2006 04/04/2007 EACH OCCURRENCE S 2,000,001 ~-OCCUR 0 ctAlMSlAADE AGGREGATE S 2,000,001 A $ R ~EOUCT1BLE S RETEtmDN S H S WORKERS COIIPENSA11ONANO APPRDV LID I\.~; ,efT ~ we ST"l"U- IOJ);'- EMPLOYERS'LIABIl1TY JNY PROPRJETORJPARTNERJEXECUTIVE '-/5 F:~j/;/ f? E.L EACH ACCIDENT S OFFtcERJM&.tBER EXClUOEM E.L DISEASE - EA EMPLOYEE $ ~.-...- c :7,-", E.L DISEASE - POliCY LMT S ECLAL PRQVJStoNS below OrnER LJa1.l.1 f"L' AS':'lsta.1 City AttOJ"'-l.e~ DESCRFnON OF OPERAlIONS J LOCAl1ONSJ~ J EXa.USIOHS ADDED BY ENDORSEIIENT J SPEClAl. PROVISIONS form .ity of Santa Ana, its off cers, agents, ~loyees, and volunteers are additional insureds as per I-NP-003 (05/01) Item M - Funding Source and Pri...ry Insurance as per form CGoo 01 07 98, both ttached to the general liability policy and acc~nying this certificate, *Except for 10 days written notice of cancellation for non-payment of premium. CE LDE C CEL ION City of Santa Ana - CDBG M-25 ESG P.O. Box 1988 M-25 Santa Ana, CA 92702 SHOULD Nf'( Of THE ABOVE DESCRJBED POUCIES BE CANCElLED BEFORE TlIE EXPlRAlJON DATE THEREOF, THE ISSUING INSURER WILL ~ MAIL 30* DAYS WRITTEN NOTICE TO THE CERTlACATE HOlDER NAMED TO THE LEFT, 16.'6lIlI~~"~~ ~lOOfM~ AU1lfORIZED REPRESENTATIVE Kathleen Benner, ACSR/KJB ACORD 25 (2001/08) FAX: (714)647-6549 C - Q - @ACORDCORPORA~ON1~