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it V% <br />ACORD CERTIFICATE OF LIABILITY INSURANCE OPIDPcDAm(Y"'DD""Y" <br />MERCY -2 <br />05/09/08 <br />PIIODUCEP <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 A-2008-068-06-01 <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 />- <br />Phone: 626-405-8031 Fax: 626-405-0585 <br />UPED - <br />INSURERS AFFORDING COVERAGE <br />_ .._- _ -- --i <br />INSUf6i <br />NAIC # <br />OENGAgL UABIL?V <br />IWUREnB Everest National <br />i 1,000,000 <br />Mercy House <br />PHPX309978 05/02/08 1 05/02/09 <br />DANvrE To r+anEo <br />PgEwses lEA ,,.nap <br />s 100,000 <br />P.O. Box 1905 <br />i. <br />Santa Ana CA 92702 <br />occLE+ <br />._... <br />! <br />I INBUPER E <br />TIIE FaLICESC INSURW USTEMI BE HAVE BEEN IWTO THE WUREO NAYN'D AB FOR TI£POUOY PEROO INOCATED. NOTMTNSTANDNG <br />ANY RIDUIREMENi. TERMORCONpT10NOF COMPACT -.T DOCUTAEFp WrTHRESPECTTONHCHTHSCERTIRGTEMAYBEISSUEDOR <br />MAY PERTAIN. TFC WURAFICE AFFORDF31 BV TFIE POLICES 0 —BEO H IN IS SLB.IECT TO ALL TPE TERIAB. EKCLUSICNS ANO LOIOITOW OF SUCN <br />POIIO�.­ELIMRSSHJMM YINVEBEFNREpUCEDB DC W <br />INSR MD -L POLICY EPFECTYE POLICY EEPIPATKIN <br />_... <br />- <br />LTfl IWPD TYPE OF INSUPgNCE POLICY NUMBER DATE(MMIDD/YY•) GTE (YWDOIYY) <br />LIYRf <br />OENGAgL UABIL?V <br />EwCR DCGUFAENCE <br />i 1,000,000 <br />A X lX cDMMEgcALce+EFaLuauTv <br />PHPX309978 05/02/08 1 05/02/09 <br />DANvrE To r+anEo <br />PgEwses lEA ,,.nap <br />s 100,000 <br />a,vMs MAGE X <br />i. <br />occLE+ <br />._... <br />! <br />•MED E%P (Am a.PMN <br />1 t 5,000 <br />X Ptofessionai <br />PEr.SOI•r.LaAw IwLTry <br />s 1,G00, 000 ' <br />I2, aqq/lmil occ <br />. <br />C£EAA AGiiWAE <br />s 2,000,000 <br />WE AGOPEG E. UNn APRJFS PER <br />Ir FAODUGIS COLPN'A(G -- <br />j s 2 000 000 <br />Ppo <br />, , <br />POLICY JECi i lDC <br />'' <br />- <br />AUTOMOBILl L4BILT' <br />I <br />A ANYAUFo PHPX309978 05/02/08 05/02/09 <br />DwTaFEnsINCIEuw <br />Ea+aM.a <br />s 1000000 <br />xLowHBT ALY� i <br />BODKYIWI.fiY <br />i SGEJIILEO AUTO6 II <br />.. I <br />IPa FaMml <br />I T <br />R �. HNED AUf05 I <br />- <br />' <br />X NON-0N*EDAUTOS <br />BODILYINI <br />I—) <br />s <br />PPOPERTV DALVGE <br />IPN ectleavl <br />I <br />$ <br />I GRADE LwsaITY <br />' � � <br />' A✓ro orav-EA AccIOENr <br />I s <br />ANY AUFO <br />EAACC <br />orHeiTHNN <br />y <br />f <br />. <br />_-- <br />AUTO OKY' <br />AGO <br />f <br />EKDES"MBRELLA UABILDY <br />i � <br />EALN OCGIEYiF.N!£ <br />iCLAYA MADE I <br />AGCiiEL4TE <br />T <br />f <br />i <br />.. { <br />• <br />... - <br />I .- _._.. _ _ __. _. _ <br />DIE I" <br />_- <br />$ <br />WOfIKCpS COYPENTATp1 AMD <br />�. <br />X ! WO STATU <br />roRY urns <br />'DTH <br />EA <br />EW+LOYERf'LIABIutt <br />B 'ArcP�PR�TORrnFaacvl� <br />6600000730071 10/01/07 10/01/08 <br />ELFACHAOODEM <br />f 1000000 <br />OFFlCEiNA'MBER IXGLLAEDT <br />- <br />.. .. - <br />D Y®. UNP:.b ur]r I <br />CL. DISEASE. EA EMPLOYEE <br />'.i 11000000 <br />9PEGK PgwBKNaS E.Iwv <br />E.L. DISEAIE-FCUOY'UMT <br />'.'f 1000000 .. <br />OTNEP <br />A Sexual Abuse PHPK309978 05/02/08 05/02/09 <br />i <br />Aggregate <br />300,000 <br />ea Muse <br />100,000 <br />DeSCq PION OF DPEgATM]Mc!LOCgT10NSIVEHCLEf/E%CLUSIp16 pOpED BY ENpppsELEHT/TPECIAL PigYCiIONT <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 a this policy is primary per the <br />attached endorsement. Horkes compensation coverage excluded, evidence only. <br />10 days notice of cancellation for non-payment of premium. <br />n=DTIMr'ATC LJ rYI n <br />a_a� I wIv <br />CITYSAN eNOUlO ANY Of THE AEOVEp®CPwEO POLICIES BE GNCEILEp PEFpiE THE EATNgATN)N <br />DATE TIFAEOf, TNf ISSUING IxSUgEp WN.L ENOEAVOP Tp Wyl 30 DAYf WRITTEN <br />City of Santa Ana <br />NOTIDC ro TME CEgTIFIGTC NOIdEp NAMED TO TIE LEFT, BUT FAILURE TO DO SO SNgLL <br />Frank Hernandez.•, <br />20 Civic Center Plaza ''' IMPOSE NO OBUGTgN OR LIANUTY Of ANY KIMD UPON TIC INTUpER ITS AGENTS OA <br />P.O. Box 1988 %��//p/,'L ,, ny REPRESENTATNEB. <br />Santa Ana CA 92702 •I�`: /`' V//� //V AU EO RE TATNE <br />25 (2001/08) -- - <br />