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01 <br />ACORD CERTIFICATE OF LIABILITY INSURANCE OERCY- <br />DATE IN" NY" <br />MERCY -2 <br />05/09/08 <br />PR—EA <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Chapman & Associates <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />License #0522024 <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P. 0. Box 5455 <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Pasadena CA 91117-0455 <br />UNDTS <br />Phone: 626-405-8031 Fax: 626-405-0585 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />' <br />INSUiED <br />11SUREH .4 NSFEi. L.. [srq <br />I—AEAB Everest National <br />s 100,000 <br />Mercy House A-2008-068-07 <br />IeuRERG <br />-- <br />P.O. Box 1905 <br />I FE]iSgIAL A ADI IWUN <br />_ <br />S 1,000,000 <br />.. <br />2mil agg/Imil occ I <br />Santa Ana CA 92702 <br />s 2,000,000 <br />INBUPER E <br />COLPIOPAGG <br />COVERAGES <br />THE PoLCIES OF INSUNW.EE LISTED BELOW NNVE BEEN ISSLED TOTHF IN3l.PFD NAKED ABOVE POR TFE PWCY PegOD IEDK:ATE0. NOIVATHSTANDNG <br />AIJY REOUIREMEM. TERM OA CONDRIONOFANI CONiPAGi OR 011lR DOCUNEN, KITH PESPECT TO N1SCM TMS CEFTIRCATE AMV BE ISSIED OR <br />HMY PERlAl1 TFE If6UfNIVIF AFFORDED BY TFIE PCUCES pBW BED EETlIN 6 Sl.B1ECT TO ALL TIE TERMS. E%QLBIONS 4N0 CONl11TON60F SUCH <br />SHOMD ANY OF THE ABOVE DESCRNIFD POUMES BE CANCELLED U14DRE THE—RATION <br />FOUCIES AGGREGATE LARDS SFIOWN NAY HAVE BEEN R®UCED BY PND CLAW <br />DATE TN EREOF, TNEISBIIINOIN&IgER—ENDEAVOR TO MNL 30 DATE V/RTTEN <br />-AIIIADD'L POUCY EFFECTYE POLICY E%PIRATX)N <br />LTR 1MAD I TYPE OF INSURANCE POLIDY'NUMBER DATEINWODM'I DATE ryrw°ml <br />UNDTS <br />DE.RRAL LIABIUTY <br />EhG1000WiERCE <br />3 1,000,000 <br />A X X i caAM LDaleawABI.TY PHPK309978 05/02/08 05/02/09Pae.Eses <br />ffADLOP.I%N <br />s 100,000 <br />1 ! CW MS LUOE R � <br />I MED Ex (AW <br />5,000 <br />X PE.oiessioaai � ' <br />- <br />I FE]iSgIAL A ADI IWUN <br />_ <br />S 1,000,000 <br />.. <br />2mil agg/Imil occ I <br />I CENEM IGGRFGAE <br />s 2,000,000 <br />(;ENL ADGPEGATEUTA <br />'l TAPRJW'm <br />COLPIOPAGG <br />S 2,000,000-_-- <br />- '- <br />FPAOg1GT3 <br />®ACORD CORPORATION 1988 <br />POUCI A:CT Ux <br />AUTOMOBILE UABILRY I <br />•, Cdf9N®SINOIEUMR <br />s 1000000 <br />A ANYAUTO PHPK309978 05/02/08 05/02/09 <br />uL GAmLDAuros j <br />J <br />_"LYINXJRV <br />i <br />. scR®IAEDAuros - <br />IPV reNm1 <br />s <br />R nweO Aurcv <br />_ I <br />BODILY MIJRY <br />S <br />X NON-0YMEDAIOS <br />114 av0RS1 <br />_ <br />PROPERTYDAAMGE <br />'. <br />� IPe Emaett <br />S <br />I GARAGE <br />I <br />AUTO OILY � EA ACCIDENT <br />s <br />ANY AU,O <br />''. OTIE3ITWN EA ACC S <br />' 1 <br />i I <br />I <br />� Aura aaY <br />ADG s <br />EXCESSNMBRs— LIABILITY I <br />Fgg106Wi@ICE <br />S <br />OCCUR j QNNBRUDE <br />AGC>A&4TE <br />S <br />.. 4- ­ <br />I � <br />i <br />DEDUCTIBLE <br />j DEDUCTIBLE <br />I, -... <br />FETENTON s <br />S <br />•. WORNERSCONPENSATONAND <br />X ! UNITU. <br />UMTS <br />OEA <br />EA <br />! EYPLOYERS'UAINITY <br />B 6600000730071 10/01/07 10/01/08 <br />PNV PfOPWE ONPARTEEREIfLCUiIVE <br />_ ,TDATRY <br />EL EAwACODEW <br />s 1000000 <br />OFRCHNEMBER ED(CLtAEO? <br />i <br />' <br />EL gsEASE. EABnP,OYEE <br />; S lOOOOOO <br />. <br />M Ya, UENc•tH u4m <br />9PECML PgOVSgNb IaM - <br />EI DISEME-P YUNIT <br />3 1000000 <br />OTHFA I. <br />A sexual Abuse PHPK309978 05/02/08 05/02/09 <br />11 Aggregate <br />300,000 <br />I <br />ea Abuse <br />100,000 <br />DESgpPTION WO TIONS! LOCATN1N31 VEHICLES/EXCLI-ONS ADDED BY ENDOISELENT/ERT IAL RADVSION3 <br />Re: CDBG and ESG grants. City of Santa Ana, its officers, employees, agents, <br />volunteers and representatives are named additional insureds with respect <br />to the operations of the named insured & this policy is primary per the <br />attached endorsement. Workes compensation coverage excluded, evidence only. <br />10 days notice of cancellation for nen-payment of premium. <br />GER IIf-IGAIE HULDER <br />CANCELLATION <br />CITYSAN <br />SHOMD ANY OF THE ABOVE DESCRNIFD POUMES BE CANCELLED U14DRE THE—RATION <br />DATE TN EREOF, TNEISBIIINOIN&IgER—ENDEAVOR TO MNL 30 DATE V/RTTEN <br />City of Santa Ana <br />NOTICE TOTNECERTIICATENOLDERgASIED TDTHELEFT, BUTFALURE TO DO EOSHALL <br />Frank Hernandez.-, <br />- <br />20 Civic Center Plaza <br />T- n <br />!'I IMPOSE MO OBUOAIgN Oq INBIUTV OF ANY KIND UPON TIE IW URER ITB AGENTS OR <br />P.O. BOX 1988 <br />REPRESENTATNES. <br />Santa Ana CA 92702/�` <br />"�j�/$/%�G' <br />V <br />Nl ED IE TATNF <br />ACORD 25 (2001/08) <br />- '- <br />®ACORD CORPORATION 1988 <br />