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<br />PRODUCER
<br />Serial # 100198 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />13LAKEMDRE & ASSOCIATES ONLY AN^ CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR •
<br />P.O. BOX X731 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
<br />SAN DIEGG, CA 929fi1 ~ CDMPANfES AFFORDING COVERAGE
<br />fi~9-222-4458 -- - - ---
<br />GoMPANY PHILADELPHIA INDEMNITY INSURANCE CO.
<br />A
<br />INSURED ~~ _ COMPANY
<br />LATINO HEALTH ACCESS g .
<br />17D1 N. MAIN 5T. ---- - ---- --
<br />I SANTA RNA, CA 9270fi COMPANY
<br />I C
<br />COMPANY
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<br />I THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELO • •EN ISSUED T ,~~ .~ ~ .ED NAMED AB
<br />W HAVE BE O THE INSUR II ~ OVE (FOR THE POLICY PERIOD
<br />fNDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCWENT WITH RESPECT TD WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED B Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />E?CCLUS!c~NS AND CONDITI~JNS OF SUCH POLICIES, LIMITS SHOII~JN MAY HAVE REE[~! REDUCI=D BY PAID CLAIMS, ,
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<br />~ CO I POLICY EFFECTIVE POLICY EXPfRAT[ON
<br />LTR TYPE OF INSURANCE II POLICY NUM$ER DATE ~MMlDDIYY) DATE {MMlDDIYY)
<br />GENERAL LIABILITY
<br />IIPHPK31~291 05/20/08 05/20/09
<br />A ~ 'COMMERCIAL GENERAL LIABILITY I
<br />I ~ CLAIMS MADE ~ QCCUR ,
<br />I C------
<br />~I dWNER'S & CONTRACTOR'S PROT
<br />•
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<br />AUTOIt~DBILE LIABILITY ~PHPK314291 0512010$ ~ 05/20/09
<br />,~ X ANY AUTO .
<br />-_
<br />'ALL OWNED AUTOS
<br />_..._~ I
<br />j SCHEDULED AUTOS I
<br />~ X ~ HIRED AUTOS
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<br />~x NON-DINNED AUTOS III. I
<br />I I 11
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<br />G~'RAGE LIABILITY '
<br />L~
<br />I I ANY AUTO
<br />II __~'I __.._._.._ _._ I
<br />II ~
<br />EXCESS LIABILITY
<br />UMBRELLA FORM
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<br />j (.OTHER THAN UMBRELLA FORM _....III
<br />WORI~(ER'S COMPENSATION AND I
<br />EIyIPLOYERS' LIABILITY
<br />THE; Ni,Gr'RIET'ORI ~ INCL
<br />PARTNERSlExECUTIVE
<br />I OFFICERS ARE: E?LCL
<br />OTHER
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<br />LIMITS
<br />GENERAL AGGREGATE $ 1 aaQaaa
<br />PRODUCTS - COMPIOP AGG $ 1 aaaoaa
<br />PERSONAL & ADV INJURY $ _
<br />1 aQaaaa
<br />EACH OCCURRENCE I $ 1 aaaaaa
<br />FIRE DAMAGE (Any one fire) $ 1 aaaaa
<br />MED EXP (Any one person) $ 5aaa
<br />COMBINED SINGLE LIMIT ~ 1 aoaa0-Q
<br />BODILY INJURY ~ $
<br />(Per person)
<br />BODILY INJURY ~
<br />(Per accident)
<br />PROPERTY DAMAGE g
<br />AUTO ONLY _ EA ACCIDENT I
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<br />- -- $
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<br />I OTHER THAN AUT6 ONLY: _.....
<br />__
<br />EACH ACCIDENT $ '
<br />AGGREGATE $
<br />EACH OCCURRENCE $
<br />AGGREGATE $
<br />
<br />+ I VtiIO STATU- 0TH- +'
<br />II TORY LIMITS ER
<br />EL EACH ACCIDENT $
<br />EL DISEASE -POLICY LIMIT $
<br />EL DISEASE - EA EMPLOYEE $
<br />I
<br />DESCRIPTION OF OPERATIONSlLOCATIONSIVEHICLESISPECIAL ITEMS
<br />1 CITY OF SANTA ANA ITS OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS IS NAMED ADDITIONAL INSURED PER ATTACHED
<br />EXHIBIT B
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<br />SHOULD -. ..
<br />~ ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BE[=pRE THE
<br />i CITY OF SANTA ANA EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL EN~Q3 MAIL
<br />+ 2Q CIVIC•CENTER PLAZA, M-21 ~0 DAYS WRITTEN NOTICE TD THE CERTIFICATE HOLDER NAMED TD THE LEFT,
<br />SANTA ANA, GA 9271 ~~~~~~~
<br />'i ~~
<br />~ AUTHORIZED REP /N IVE BLAf4EMORE•~ ASS CIATES
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