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From: Jessipl Raya-Ellis At: Olapman & Associates FaxlD: Olapman Associates To: Laura Sheedy Date: 7/2312007 11 :35 AM Page: 2 of 4 ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID 2~ DATE (IIM1DO/VYYY) MERCY-2 07/23/07 PRO OUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Chapman & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License '0522024 HOLDER. THIS CERTIFICATE POES NOT AMEND, EXTEND OR P. O. Box 5455 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Pasadena CA 91117-0455 Phone: 626-405-8031 Fax: 626-40S-0585 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A Philadelphia Insunnce Company INSURER 8, Mercy House ,OC,SURER C P.O. Box 1905 INSURER D Santa Ana CA 92702 IN:3IJRER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING Al'JY 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 F'OLlCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOVlIN MAY HAVE BEEN REDUCED BY PAID CLAIMS, '~~ ~~~ TYPE OF INSURANCE POLICY NUMBER ~~IEf~ !P?~~YI~,~!,=N LllIrrs DATE MMlDD DATE MWD I GENERAL LIABILITY EACH OCCURRENCE $1,000,000 - A X ~ C(>MMERCIAL GENERAL LIABILITY PHPK231259 OS/02/07 05/02/08 PREMISES (Ea OCCL<ence) $100,000 - b CLAlMSWoDE ~ OCCUR MED EXP (Anyone person) $ 5,000 ~ professional PERSONAl & ADV INJURY $1,000,~00 _ 2mil agg/1mi~ occ I GEfoERAL AGGREGATE $2,000,000 i GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS. COMP/OP AGG $2,000,000 I POLICY n j~& n LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - $ 1000000 A ANY AUTO PHPK231259 OS/02/07 05/02/08 (Ee accident) f-- ALL OWNE D AUTOS BOOIL Y INJURY f-- $ S':HEDULED AUTOS (Per person) f-- X HIRED AUTOS BODILY INJURY f-. $ ~ NON-OWNED AUTOS (Per aCCldentl ~ ----- PROPERTY DAMAGE $ I Per accident) GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $ R ANY ALlTO OlHER lHAN EAACC $ f'iJrO ONLY: AGG $ EXCESSlUMBRELLA LIABILITY pC R\\I1 EACH OCCURRENCE $ tJ 'oCCUR D CLAIMS MADE A1?FRO'(~D AS 'to AGGREGATE $ .' 13 $ R DEDUCTIBLE . ~--~ ~-/J4I . 01 ~ J / ( $ -- RETENTION $ hi' ,., $ WORKERS COMPENSATION AND - , UA'1.>!a ;t~~~ v - IT~c;,IT~m I IO~ EMPLOYERS' lIABUTV ~i' Attorne ANY PROPRIETORIPAATNERlEXECLlTIVE ASslstant E,L EACH ACCIDENT $ ..- OFFICE~IMEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ ~~~21~~~~)t~~~~s below EL DISEASE. POLICY LIMIT $ OlHER A Sexual Abuse PHPK2312S9 OS/02/07 OS/02/08 Aggregate 300,000 ea Abuse 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDEO BY ENDORSEMENT I SPECIAL PROVISIONS Re: CDBG and ESG grants. City of Santa Ana, its officers, employees, agents, volunteers and representatives are named additional insureds with respect to the operations of the Damed iDsured & this po~icy is primary per the attached Exhibit B endorsement. 10 days notice of cancellation for nOD-payment of premium. CERTIFICATE HOLDER CANCELLATION Ci ty of Santa Ana Frank Hernandez 20 Civic Center Plaza P.O. Box 1988 Santa Ana CA 92702 CJ:TYSAN SHOULD /W'( OF lHE ABOVE DESC~BED POLICIES BE CANCELLED BEFORE lHE EXPIRATION DATE lHEREOF, THE ISSUING INSURER WLL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO lHE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABR.1TY OF AHf KIND UPON Tl<E INSLftER, rrs AGENTS OR REPRESENTATIVES, A 0 REPR @ACORDCORPORATION 1988 ACORD 25 (2001/08)