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Client#• 2L IVCRE ODCORU. CERTIFICATE OF LIABILITY INSURANCE 0DATE (M 9/11/9/111M/DD/YYYY) PRODUCER 09 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Willis Insurance Services of CA, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3536 Concours, Suite 220 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Ontario, CA 91764-5594 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. License #0371719 INSURED INSURERS AFFORDING COVERAGE NAIC # Olive Crest Treatment Centers Inc INSURERA: Philadelphia Indemnity 18058 2130 E. Fourth St., Ste. 200 INSURERS: Santa Ana, CA 92705 INSURERC: INSURER D: INSURER E: COVERAGES 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 BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR OD' LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICYDATE EFFECTIVE E TIV£ FOLIC -EXPIRATION X IIR TION YYj LIMITS A GENERAL LIABILITY PHPK464966 09/01/09 09/01/10 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED I ncel$1000,000 CLAIMS MADE a OCCUR MED EXP (Any one person) $20 000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE s3.000000 GEN'L AGGREGATE LIMIT APPLIES PER: �0'� POLICY PRODUCTS -COMP/OP AGG s3,000,000 PRO- LOC JECT AUTOMOBILE LIABILITY �t N- �$o V� - COMBINED SINGLE LIMIT $ ANY AUTO 7ti (/ CO (Ea accident) ALL OWNED AUTOS L- OR�j\k SCHEDULED AUTOS ,SP E Ptt0061 (Per person) RY $ HIRED AUTOS 55 S�a`n{ C`ty NON -OWNED AUTOS P I BODILY INJURY (Per accident) $ l / PROPERTY DAMAGE $ / (Per accident) GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESS/UMBRELLA LIABILITY PHUB283481 09/01/09 09/01/10 EACH OCCURRENCE $10 000 000 OCCUR I —XI CLAIMS MADE AGGREGATE $10 000 000 XIX RETENTION $ 1 OOOO WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY ER ANY PROPRIETOMPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? If yes, describe under E.L. DISEASE - EA EMPLOYEE $ SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ OTHER A ABUSE PHPK464966 09/01/09 09/01/10 $1,000,000 / $1,000,000 A PROFESSIONAL LIAB PHPK464966 09/01/09 09/01/10 $1,000,000 / $3,000,000 A IEE DISHONESTY PHPK464966 09/01/09 09/01/10 $500,000 / $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS THIS CERTIFICATE AMENDS & SUPERCEDES CERTIFICATE DATED 09/08/09 RE: Grant Certificate Holder is Additonal Insured per'Additional Insured Endorsement for Commercial General Liability Policy' attached (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN 20 Civic Center Plaza NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Santa Ana, CA 92701 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTA S. AUTHORIZED EP E ACORD 25 2001l08 ( ) 1 of 3 #S647555/M647173 2DADA © ACORD CORPORATION 1988