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<br /> ~" CERTIFICATE OF LIABILITY INSURANCE \ DATE (MMJDOJYYYYl <br /> 04/17/2008 <br /> 'RODUCER (714)838-1912 FAX (714) 838-7568 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Lake Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 13891 Newport Ave., Suite 285 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Li c 10747473 <br /> Tust;n, CA 92780 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED Carrbodian Family INSURER A: Philadelphia Ind. Ins. Co. <br /> 1111 East Wakeham Avenue INSURER B: philadelphia Insurance Co. <br /> Suite E INSURER c' K.Freeman/Philadelphia Ind. <br /> Santa Ana, CA 92705 INSURER 0: <br /> INSURER E: <br /> Cnv <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 /> IN.!i~ ~~<rk TYPE OF INSURANCE POUCY NUMBER ~!-.!.sy EFFECTIVE PQUCY EXP1RATlON UMITS <br /> ~NERAl. UABIUTY PHPK290824 03/09/2008 03/09/2009 EACH OCCURRENCE . l,OOO,OOC <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED . 100,OOC <br /> I CtAIMS MADE 00 OCCUR MEO EXP (My one persoo) . 5,OOC <br /> A - PERSONAL & ADV INJURY . l,OOO,OOC <br /> f-- GENERAL AGGREGATE . 3,OOO,OOC <br /> h'~AGG~En LIMIT APPlS PER: PRODUCTS. COMP10P AGO . l,OOO,OOC <br /> POLICY ~~8T lOC <br /> ~TOMOBILE LIABILITY PHPK290824 03/09/2008 03/09/2009 COMBINED SINGLE UMIT <br /> ANY AUTO (Eaaccldant) . 1,000,000 <br /> - <br /> I - ALL OWNED AUTOS <br /> BODilY INJURY <br /> SCHEDULED AUTOS (Pltf"person) . <br /> A T <br /> HIRED AUTOS <br /> ~ BODll Y INJURY . <br /> ~ NON-OWNED AUTOS (Per accident} <br /> f-- PROPERTY DAMAGE . <br />! (Peracadernl <br />I ~~DE LIABILITY AUTO ONLY - EA ACCIDENT . <br /> ANY AUTO ..ACC . <br /> OTHER Tl-lAN <br /> AUTO ONLY: AGG . <br /> :::JESs/U.BRELLA LIABILITY EACH OCCURRENCE . <br /> OCCUR 0 CLAIMS MADE AGGREGATE . <br /> . <br /> R DEDUCTIBLE ~ ~ lie . <br /> RETENTION . -J' -' ,,,,Ie . . <br /> WORKERS COMPENSATION AND I T.wc ST~,U', I IDJ,t', <br /> EMPLOYERS' UABlUTY <br /> ANY PROPRIETORJPARTNER/EXECUTIVE E,l. EACH ACCIDENT . <br /> OFFICERlMEMBER EXCLUDED? <br /> If ye8. describe under E.L DISEASE - EA EMPLOYE . <br /> SPECIAl PROVISIONS beloW E.L DISEASE. POLICY LIMIT . <br /> AGrER PHPK290824 03/09/2008 03/09/2009 $1,000,000 Each Claim <br /> use & Molestation <br /> A $1,000,000 Aggregate <br />~DEESCRlPTION OF OPERATlONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROvtSIONS <br /> Except 10 days for non payment of premium. Employee Dishonesty $200,000/$2,500 Oed. <br /> ity of Santa Ana is named additional insured per contract with named insured. <br /> ~10 days Notice of Cancellation shall be given in the event of non-payment of premium. <br /> <br />- <br /> <br />'...,...... <br /> <br />The City Of Santa Ana: Its Officers,Employees <br />Agents, representatives <br />20 Civic Center Plaza (M-30) <br />Santa Ana, CA 92705 <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL 1tX:I:X.~ MAIL <br />30* DAYS WRITTEN NonCE TO THE CERTlACATE HOLDER NAMED TO THE L.EFT, <br />~~XJllUllfll0iltlOOl1iX~X <br />~lIJ(lllOOOOIlilOtXXIOOtXllKMIOO'-Y~XXXXXXXXX <br />AUTHORlll!D1tEPRES~ATIVE: /.." <br /> <br />ACORD 25 (2001/08) FAX: (714) 571-1974 <br /> <br />~ACORD CORPORATION 1988 <br />