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C-0-0p CERTIFICATE OF LIABILITY INSURANCE OP ID PC DATE(MWDONYYY) MERCY-2 1 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. 0. Box 5455 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Pasadena CA 91117-0455 Phones 626-405-8031 Fax s 626-405-0585 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Philadelphia Insurance CorVany INSURERS: Everest National Mercy House INSURERO: P.O. BOX 1905 INSURER D: Santa Ana CA 92702 INSURER E: UVEMAUIZO 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. IRS LTR NSA TYPE OF INSURANCE POLICYNUMBEA CY DATE AMMD qq A D TE MIOD LIMITS GENERALLIABIUTY EACH OCCURRENCE $ 1 000 000 A X X COMMERCIAL GENERALLIA.BuTY CLAIMS MADE a OCCUR PHPK309978 05/02/09 05/02/10 PREMISES Eaoccurence $ 100 000 LIED EXP (Arty one person) $ 5 , 000 X Professional NO DEDUCTIBLE PERSON& &ADV INJURY $ 1 000 000 2mil agq/lmil Occ GENERALAGOREGATE $ 2 00O 000 GENtiAGGREGATELIMIT APPLIES PER: X POLICY 2 LOC PRODUCTS -COMP/OPAGG 1$2,000,000 A AUTOMOBILE LIABILITY X ANYAUTO PHPK309978 05/02/09 05/02/10 COMBINED SINGLE LIMIT (Eaaccidenp $ 1000000 ALL OW WO AUTOS SCHEDULEDAUTOS NO DEDUCTIBLE BOp1YINJURY (Per person) $ X HIRFDAUTOS X NONOYNEDAUTOS 80DILYINJURY (PerecddM) $ PROPERTY DAMAGE (Per ecddeni) $ GARAGE LIABILITY APPROV D AS TO FOR AUTO ONLY- EAACCIDENT $ ANY AUTO �f-` , THAN EA ACC OTHER AUTO ONLY: AGG $ $ EXCESSNMBRELLALABILITY OCCUR CLAIMSMADE Lau Assist a Sti S edc ut ity Atto y ney EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY P ROPRIETOKPARTNEMXECUT IVE OFFICER/MEMBEREXCLUDED? If Yes Aesabe CIAL PROVISIONS beforr PROVISIONS 6600000730081 NO DEDUCTIBLE 10/01/08 10/01/09 X TORYUMfTS 1H E.LEACHACCIOENT $1000000 E.L. DISEASE• EA EMPLOYEE $ 1000000 E.L.under DISEASE • POLICY LIMIT $ 1000000 OTHER A Sexual Abuse PHPK309978 05/02/09 05/02/10 Aggregate 1,000,000 NO DEDUCTIBLE I ea Abuse 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED 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 ClANCFI I ATION City of Santa Ana Frank Hernandez 20 Civic Center Plaza P.O. Box 1988 Santa Ana CA 92702 cITYSAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEDBEFORETHEEXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURETO DO 80 SHALL IMPOSE NO OBLIGATION OR LIABILITYOF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. 25 (2001/08)