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C-00. CERTIFICATE OF LIABILITY INSURANCE OP ID PC DATEQMMNDl1'" MERCY-2 05/05/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO Chapman ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License #0522024 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. O. Box 5455 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Pasadena CA 91117-0455 Phone:626-405-8031 Fax:626-405-0585 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Philadelphia insurance canpany INSURERS: Everest National Mercy House INSURERC: P.O. Box 1905 INSURERD: Santa Ana CA 92702 INSURER E. JYGnAuca 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 OFANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE 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. ILTR NSR TYPE OF INSURANCE POLICYNUMBEA POLIO FFEC DATE AI PO Y DATE D LIMITS GENERALLIABILITY EACHOCCURRENCE $ 1,000,000 A X X COMMERCIALGENERALLIABIUTY CLAIMS MADE ❑X OCCUR PHPK309978 05/02/09 05/02/10 PREMISES Eaocarenee) $ 100 000 MED EXP (Anyone person) $ 5 , 000 X Professional NO DEDUCTIBLE PERSONAL & ADV INJURY $ 1 000,000 2mil aEg/lmil o00 GENERAL AGGREGATE $ 2 000 000 GEN'LAGGREGATE LIMIT APPLIES PER-PRODUCTS-COMP/OPAGG X POLICY jE LOG $2,000,000 A AUTOMOBILE LIABILITY X ANYAUTO PHPK309978 05/02/09 05/02/10 COMBINED SINGLE LIMIT (Eaaatdeni) $1000000 ALL OWNED AUTOS SCHEDULEDAUTOS NO DEDUCTIBLE BODILYIN.RIAY (Per person) $ X HIREDAUTOS X NONOYNEDAUTOS BOD>LYINJURY (Petsoddent) $ PROPERTYDAMAGE Per ecddent) S GARAGELIABILITY APPROVED AS TO FORM AUrooNLY-EA ACCIDENT $ ANY AUTO ,AUTOONLY: OTHEEA ACC R THAN AGG $ $ EXCESSNMBRELIALIABIL►TY OCCUR CLAIMS MADE u !Assist S St1 Shee nt ity Atto'ney y EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ ' $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPR'LIABIARTNEIVEXECUTNE OFFICEFyAFJATMOLUF 11 yes ALde3almPRO under S SPECIAL PROVISIONS bebN 6600000730081 NO DEDUCTIBLE. 10/01/08 10/01/09 X I TORY LIMITS ER E.L. EACH ACCIDENT $1000000 E.L. DISEASE -EA EMPLOYEE $ 1000000 E.L. DISEASE •POLIGYLIMIT $ 1000000 OTHER PK309978 05/02/09 05/02/10 Aggregate 1,000,000 PHPK309978 A Sexual Abuse F0N Iea Abuse 1,000,000 DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES / EXCLUSIONS ADDEO BY ENDORSEMENT/ SPECIAL PROVISIONS Res CDBG and ESO grants. City of Santa Ana, its officers, employees, agents, volunteers and representatives are named additional insureds with respect to the operations of the named insured & this policy is primary per the attached endorsement. Workes compensation coverage excluded, evidence only. 10 days notice of cancellation for non-payment of premium. CERTIFICATE HOLDER CANCELLATION City of Santa Ana Frank Hernandez 20 Civic Center Plaza P.O. Box 1988 Santa Ana CA 92702 25 (2001/08) CITXSAN SHOULD ANY OFTHEABOVEDESCRIBED POLICIES BECANCELLEDBEFORETHE! EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITYOF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, C I IN i