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ACMD, CERTIFICATE OF LIABILITY INSURANCE <br />DATE <br />04/03/20 8) <br />PRODUCER (310)393-9477 FAX (310)393-7186 <br />White & Company Insurance Inc <br />P 0 Box 70 <br />Santa Monica, CA 90406-0070 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURED Women's Transitional Living Center <br />PO Box 6103 <br />Orange, CA 92863 A-2008-069-73 <br />INSURERA: Philadelphia Ins Co <br />INSURER B: <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />rnVFRerFR <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 />INSR <br />DD' <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />DATE IMMIDDIYY) <br />LIMITS <br />GENERAL LIABILITY <br />PHPK302718 <br />04/04/2008 <br />04/04/2009 <br />EACH OCCURRENCE $ 1,000,000 <br />)( COMMERCIAL GENERAL LIABILITY <br />DAMAGE TO RENTED $ 100,000 <br />CLAIMS MADE F5C] OCCUR <br />MED EXP (Any one person) $ 15,000 <br />PERSONAL & ADV INJURY $ 1,000,000 <br />A <br />GENERAL AGGREGATE $ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG $ 1,000,000 <br />POLICY F1 PROECT LOC <br />J <br />AUTOMOBILE <br />LIABILITY <br />PHPK302718 <br />04/04/2008 <br />04/04/2009 <br />COMBINED SINGLE LIMIT <br />ANY AUTO <br />(Ea accident) $ <br />1,000,000 <br />BODILY INJURY <br />$ <br />ALL OWNED AUTOS <br />X <br />SCHEDULED AUTOS <br />(Per person) <br />A <br />BODILY INJURY $ <br />X <br />HIRED AUTOS <br />X <br />NON -OWNED AUTOS <br />(Per accident) <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EA ACC $ <br />ANY AUTO <br />AUTO ONLY: AGG $ <br />EXCESS/UMBRELLA LIABILITY <br />PHUB236049 <br />04/04/2008 <br />04/04/2009 <br />EACH OCCURRENCE $ 2,000,000 <br />X OCCUR F-1 CLAIMS MADE <br />AGGREGATE $ 2,000,000 <br />A <br />$ <br />$ <br />DEDUCTIBLE <br />X RETENTION $ 10,000 <br />$ <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITYFORM <br />� <br />WC STATU• OTH- <br />E.L. EACH ACCIDENT $ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. DISEASE - EA EMPLOYE $ <br />OFFICERIMEMBER EXCLUDED? <br />Ifyes.describe under <br />E.L. DISEASE - POLICY LIMIT 1 $ <br />SPECIAL PROVISIONS below <br />OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />ity of Santa Ana, its officers, agents, employees, and volunteers are additional insureds as per form <br />I -NP -003 (9/03) Item M - Funding Source and Primary Insurance as per form CG00 01 1204, both <br />attached to the general liability policy and accompanying this certificate. <br />*Except for 10 days written notice of cancellation for non-payment of premium. <br />City of Santa Ana - CDBG M-25 <br />ESG <br />Attn: Frank Hernandez <br />P.O. Box 1988 M-25 <br />Santa Ana, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WALL ENDEAVOR TO MAIL <br />3V DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />OF ANY VINO UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2001/08) 1 -AR: (/14)64/-6549 ©ACORD CORPORATION 1988 <br />