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<br />Ac.oea.. CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY) <br />04/18/2007 <br />:ODUCER (310)393-9477 FAX (310)393-7186 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />hite & Company Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />I 0 Box 70 A -200'1__'0 I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />ianta Monica, CA 90406-0070 <br /> INSURERS AFFORDING COVERAGE NAIC# <br />lURED Women's Transitlonal LlVing Center INSURER A:. Philadelphia Ins Co <br />PO Box 6103 INSURER B: <br />Orange, CA 92863 INSURER, c: <br /> INSURER D: <br /> INSURER E: <br /> <br />:')VERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />"NY REQUIREMENT, TERM OR CONDITION OF AN'( 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 />~~~1 lYPE OF INSURANCE POLICY NUMBER POlICY EFFECllVE POLICY EXPIRATION UMITS <br />GENERAL UABlUTY PHPK225850 04/04/2007 04/04/2008 EACH OCCURRENCE $ I,OOO,oo(J <br />- <br />X COMMERCIAl GENERAL LIABIUTY DAMAGE TO RENTED $ 300,00(J <br /> I CLAIMS MADE [K] OCCUR MED EXP (Any one person) $ 5,OO(J <br /> PERSONAl.. & AllV INJURY S 1, 000, OO(J <br />- 2,OOO,00(J <br /> GENERAl AGGREGATE S <br />- 1. 000 , OO(J <br />GEN'L AGGREGATE UMIT APPLIES PER: PRODUCTS-COM~OPAGG $ <br />I POLICY n ~~ n LOC <br />AUTOMOBILE UABIUTY PHPK225850 04/04/2007 04/04/2008 COMBINED SINGLE LIMIT <br />- $ <br /> ANY AUTO (Ea accident) 1,000,00(J <br />- <br /> ALL OWNED AUTOS BODILY INJURY <br />- $ <br />X SCHEDULED AUTOS (Per person) <br />- <br />X HIRED AUTOS BODILY INJURY <br />X $ <br />NON-OWNED AUTOS (Per accident) <br />- <br />I-- PROPERTY DAMAGE $ <br /> (Per eccident) <br />GARAGE UABlUTY AUTO ONLY.. EA ACCIDENT $ <br />R ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG S <br />EXCESSlUMBRELLA UABlUTY PHUB082672 04/04/2007 04/04/2008 EACH OCCURRENCE S 2,OOO.00( <br />o OCCUR D CLAIMS MADE AGGREGATE S 2,OOO,00( <br /> s <br />-R DE~UCTlBLE s <br /> RETENTION $ APPROVED) (~ 'Tn 1-;'I1U "J" S <br />WORKERS COMPENSATION AND .~ 1.YJ.~JTffm;, I IO.m- <br />EMPLOYERS' UABlUTY ~LJ ~ /// <br />IWY PROPRIETORIPARTNERlEXECUTIVE ~~ R- E.L. EACH ACCIDENT S <br />OFFICER/MEMBER EXCLUDED? - E.L. DISEASE - EA EMPLOYEE S <br />If yes, de8cribe W1der c.,<!um St.i. t S.16edy <br />SPECIAl PROVISIONS below . . . E.L DISEASE.. POLICY LIMIT $ <br />OTHER U.1. '-'.11 A.[[orney <br />lCRlPTlON OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />:y of Santa Ana, its officers, agents, employees, and volunteers are additional insureds as per form <br />.NP-003 (9/03) Item M - Funding Source and Primary Insurance as per form CGOO 01 1204, both <br />:ached to the general liability policy and accompanying this certificate. <br />xcept for 10 days written notice of cancellation for non-payment of premium. <br /> <br />IC <br /> <br /> <br />City of Santa Ana - COBG M-25 <br />Attn: Frank Hernandez <br />P.O. Box 1988 M-25 <br />Santa Ana, CA 92702 <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POUClES BE CANCE1.LED BEFORE TlIE <br />EXPIRATION DAJE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />30* DAYS WRITTEN NOTICE TO TlIE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR UABlLrrY <br />OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />AUTlIORlZED REPRESENTATIVE <br />Kathleen Benner, ACSR KJB <br /> <br /> <br />ORD25(2001/08) FAX: (714)647-6549 <br /> <br />@ACORD CORPORATION 1988 <br />