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ACC4. ..ATIFICATE OF LIABILITY INSURANCE <br />08/29/wyYYYI <br />08/29/2008 <br />PRODUCER (714)838-1912 FAX (714)838-7568 <br />Lake Insurance Agency <br />13891 Newport Ave., Suite 285 <br />Lic #0747473 <br />Tustin, CA 92780 <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 Orange County Children's Therapeutic <br />Art Center, Inc N, -_200�-073 <br />2215 N. Broadway <br />Santa Ana, CA 92706 <br />INSURERA. Philadelphia Insurance Co. <br />INSURER B' <br />INBURERC <br />INSURER D: <br />INSURER E. <br />COVERAGES <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 />ADD`L <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE IMIIUDD� <br />12/21/2007 <br />POLICY <br />DATE,EXPIRATION <br />LIMITS <br />PO BOX 1988 <br />OFANYKINDUPON EINSURE. ITS AGENTS OR REPRESENTATIVES. <br />GENERAL LIABILITY <br />PHPK281597 <br />12/21/2008 <br />EACH OCCURRENCE S 1,000,00 <br />X COMMERCIAL GENERAL LIABILITY <br />DAMAGE TO RENTED $ 100.000 <br />CLAIMS MADE OCCUR <br />MED EXP(Anyene Person) $ S,OD <br />A <br />PERSONAL& ADV INJURY $ 11000,00 <br />GENERAL AGGREGATE $ 2,000,00 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />X POLICY PRO LOC <br />ECT <br />PRODUCTS - COMP/OP AGO $ 2,000,00 <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />PHPK281597 <br />12/21/2007 <br />12/21/2008 <br />COMBINED SINGLE LIMIT $ <br />(Ea ae derd) 1.000,00 <br />BODILY INJURY S <br />(Per parsm) <br />A <br />X <br />X <br />ALL OWNED AUTOS <br />SCHEDULED AUTO$ <br />HIREDAUTOS <br />NON -OWNED AUTOS <br />'^ �® <br />1 <br />BOD ILYIe$ <br />(Per strident) nt) <br />PROPERTY DAMAGE $ <br />(Per amdent) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />ANY AUTO <br />> <br />- <br />Zed <br />OTHER THAN EA ACC $ <br />AUTO ONLY: AGO S <br />E%LESSlUNBRELLA LIABILITY <br />OCCUR CLAIMS MADE <br />EACH OCCURRENCE 3 <br />AGGREGATE $ <br />DEDUCTIBLE <br />RETENTION $ <br />$ <br />WORKERS COMPENSATION AND <br />WC STAU-OTH- <br />9 FR <br />EMPLOYERS' UABIUTY <br />E. L. EACH ACCIDENT $ <br />ANY PROPRIETORIPARTNER/EXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />K yes, cescribe under <br />SPECIAL PROVISIONS below <br />E L. DISEASE -EA EMPLOYE $ <br />E DISEASE -POLICY LIMIT E <br />A <br />Professional Liability <br />PHPK291597 <br />12/21/2007 <br />12/21/2008 <br />Incident Limit: $1,000,000 <br />Aggregate Limit: $2,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />Certificate holder is Additional Insured as per form CG2026 <br />Abuse & Molestation is included with General Libility, $25,000 Each Incident and $50,000 Aggregate <br />10 Day notice for non-payment of premium <br />CFRTIFICATF MOI nFR CAMCFI I ATHMM <br />ACORD 25 (2001108) CACORD CORPORATION 1988 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />The City of Santa Ana <br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />Attn: Frank Hernandez <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />PO BOX 1988 <br />OFANYKINDUPON EINSURE. ITS AGENTS OR REPRESENTATIVES. <br />Santa Ana, CA 92702 <br />AUTHORIZED REP E Ff <br />�� <br />ACORD 25 (2001108) CACORD CORPORATION 1988 <br />