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If <br />ACORD CERTIFIQ ! `SCE <br />. OF LIABILITY INSUR <br />Lake Insurance Agency <br />13891 Newport Ave., Suite 285 <br />Lic #0747473 <br />Tustin, CA 92780 <br />1111 East Wakeham Avenue <br />Suite E <br />Santa Ana, CA 92705 <br />INSURERS AFFORDING COVERAGE <br />DATE (n <br />02/03/2006 <br />ATTER O NFORMATION <br />)N THE CERTIFICATE <br />)T AMEND, EXTEND OR <br />Y THE POLICIES BELOW. <br />NAIC # <br />Co. <br />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 CONTRACTOR 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 LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR <br />TYPE OF MSURAIICE <br />POUCY IAILKER <br />DATE <br />DATE <br />LINTS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE O OCCUR <br />PHPK155246 <br />03/09/2006 <br />03/09/2007 <br />EACHOCCURRENCE <br />s 1 000, <br />PREMISES Ea oavrarc <br />, 400, <br />MED EXP (MYane person) <br />$ 5, <br />PERSONAL BADVINJURY <br />$ 1,000, <br />GENERAL AGGREGATE <br />$ 3 000 <br />GEN'POLICY ]JPERCT-APPLIESPER <br />POLICY � LOC <br />PTO TS- COMP/OPAGG <br />S 1 000 <br />AUTOMOBILELMBILRY <br />ANY AUTO <br />ALL OWNED AUTOS <br />PHPKISS246 <br />03/09/2006 <br />03/09/2007 <br />COMBINED SINGLE LIMB <br />(Ea aCdtlml) <br />S <br />1,000, ON <br />Per INJURY <br />(Pa <br />( pnsan) <br />= <br />A <br />SCHEDULED AUTOS <br />HIREDAVTOS <br />X <br />BODILY INJURY <br />(Per acident) <br />$ <br />X <br />NO"WNEDAUrOS <br />X <br />SO Deductible <br />PROPERTY DAMAGE <br />(Per occident) <br />$ <br />GARAGE LIABILITY <br />ANYAUTO <br />AUTO ONLY- EMACCIDEWr <br />$ <br />OTHER THAN <br />AUTO ONLY: <br />S <br />S <br />EXC ESSAIMBRELLA LIABRRY <br />OCCUR ❑CLAIMS MADE <br />' , :. r _... <br />^AGGREGATE <br />EACH OCCURRS <br />f <br />DEDUCTIBLE <br />RETENTION S <br />L <br />(L <br />I '.: -✓:.�� <br />:L Attor�.ey <br />S <br />$ <br />$ <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABILRy <br />ANY PROPRIETORPARTNERIEXECInryE <br />OFFICERIMEMBER EXCLUDED? <br />TORY LIMR3 ER <br />E.L. EACH ACCIDENT <br />S <br />E.L. DISEASE- EA EMPLOYE <br />$ <br />I describe under <br />SPECIAI. PROVISIONS below <br />OTHER <br />E.L DISEASE - POLICY LJMR <br />$ <br />PHPKISS246 03 09 <br />A use bMolestation / /2006 03/09/2007 $1,000,000 Each Claim <br />$1,000,000 Aggregate <br />DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY EEO-r EMEn /SPEOUIL PRWL910Ng $O Deductible <br />Except 10 days for non payment of premium. Employee Dishonesty $200,000/52,500 Ded. <br />rofessional Liability $1,000,000 Each Occ /53,000,000 Aggregate. City of Santa Ana <br />IS named additional insured per contract with named insured. Schedule of vehicles <br />nd drivers on file. "Non Profit organization" <br />r FDTCN�ATC un, nne <br />City of Santa Ana <br />Community Development Agency <br />CDBG -M -25 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />ACORD 25 (2001108) FAX: (714)571 -1974 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL NX)OOOM MAIL <br />30? DAYS WRITTEN NOTICE TO THE CERTIRCATE HOLDER NAMED TO THE LEFT, <br />`� <br />