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DATE(MMIDD/YYYY) <br />T. .,1TIFICATE OF LIABILITY INSURANCE os/29/zoos <br />PRODUCER (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 />Lic #0747473 <br />Tustin, CA 92780 <br />INSURED Orange County Children's Therapeutic <br />Art Center, Inc <br />2215 N. Broadway <br />Santa Ana, CA 92706 <br />OVERAG <br />INSURERS AFFORDING COVERAGE I NAIC # <br />INSURERA.. Philadelphia Insurance Co. <br />INSURER B. <br />INSURER C: <br />INSURER D: <br />INSURER E. <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 />INSR <br />ADD' <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />GENERAL LIABILITY <br />PHPK281597 <br />12/21/2007 <br />12/21/2008 <br />EACH OCCURRENCE <br />$ 11000,000 <br />DAMAGE TO RENTED <br />$ 100,000 <br />X COMMERCIAL GENERAL LIABILITY <br />MED EXP (Any one person) <br />$ 5,000 <br />CLAIMS MADE JAIOCCUR <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />A <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GEN'L AGGREGATE_ LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG <br />$ 2,000,000 <br />X j POLICY jE LOC <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />PHPK281597 <br />12/21/2007 <br />12/21/2008 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />1,000,000 <br />BODILY INJURY <br />(Per person) <br />$ <br />i <br />A <br />X <br />X <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />I <br />�� <br />��' <br />BODILY INJURY <br />(Per accident) <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />GARAGE LIABILITY <br />ANY AUTO <br />I <br />-/ <br />/ ._i <br />. <br />— <br />`_ <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHER THAN EA ACC <br />AUTO ONLY: AGG <br />$ <br />$ <br />EXCESSIUMBRELLA LIABILITY <br />�' l <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />OCCUR 71 CLAIMS MADE <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />WORKERS COMPENSATION AND <br />WC STATU- OTH- <br />Y1111GFR <br />E.L. EACH ACCIDENT <br />$ <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />E.L. DISEASE - EA EMPLOYEE <br />S <br />If yes, describe under <br />SPECIAL PROVISIONS Wow <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />A <br />OTH <br />Professional Liability <br />PHPK281597 <br />12/21/2007 <br />12/21/2008 <br />Incident Limit: $1,000,000 <br />Aggregate Limit: $2,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />ertificate holder is Additional Insured as per form CG2026 <br />%buse & Molestation is included with General Libility, $25,000 Each Incident and $50,000 Aggregate <br />'-10 Day notice for non-payment of premium <br />,"Akfe`=l I Ar1nu <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />The City of Santa Ana <br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />Attn • Frank Hernandez <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />PO BOX 1988 <br />OF ANY KIND UPON xpE INSUREfj ITS AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRE �11iVEje;p <br />Santa Ana, CA 92702 <br />ACORD 25 (2001108) ©ACORD CORPORATION 1988 <br />