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U .....DATE( A C,Cob ft 05/23/2008 PRODUCER Serial# 100198 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BLAKEMORE & ASSOCIATES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. BOX 7737 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. DIEGO, CA 92167 COMPANIES AFFORDING COVERAGE 619SAN -222-4458 COMPANY PHILADELPHIA INDEMNITY INSURANCE CO. A INSURED COMPANY LATINO HEALTH ACCESS B 1701 N. MAIN ST. COMPANY SANTA ANA, CA 92706 C COMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED B Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL LIABILITY PHPK314291 05/20/08 05/20/09 GENERAL AGGREGATE $ 1000000 PRODUCTS - COMP/OP AGG $ 1_000000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR PERSONAL & ADV INJURY $ 1000000 EACH OCCURRENCE $ 1000000 OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Anyone fire) $ 100000 MED EXP (Anyone person) $ 5000 AUTOMOBILE LIABILITY PHPK314291 05/20/08 05/20/09 A X ANY AUTO COMBINED SINGLE LIMIT $ 1000000 ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) X HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACHACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ A $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY TWC STATU- JOTH- I CRY LIMITS ER F EL EACH ACCIDENT $ THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE EL DISEASE - POLICY LIMIT $ OFFICERS ARE EXCL t"IV t c, EL DISEASE - EA EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVENICLESISPECIAL ITEMS CITY OF SANTA ANA ITS OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS IS NAMED ADDITIONAL INSURED PER ATTACHED EXHIBIT B SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF SANTA ANA EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL EPb5A26i0% MAIL 20 CIVIC CENTER PLAZA, M-21 30 SANTA ANA, CA 92701 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, AUTHORIZED REPRESENTATIVE BLAKEMORE & ASSOCIATES ia 4-524. mw zm -p- CAFMPRONCERTPROS LATINOHEALTHACCESS.FP5