WTLC (WOMEN'S TRANSITIONAL LIVING CENTER

Home Browse Search

DATE AGDRDU CERTIFICATE OF �IABlLITY INSURANCE 04/16/2009) PRODUCER (310) 393-9477 FAX (310) 393-7186 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION White & Company Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O Box 70 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Santa Monica, CA 90406-0070 INSURERS AFFORDING COVERAGE NAIC # INSURED Women' a Transitional Living Center INSURERA Philadelphia Ins Co PO Box 6103 INSURER B: Orange, CA 92863 INSURER C: INSURER D: INSURER E: ., 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. fNSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECT]VE DATE tmwjpa= POLICYEXPIRATION DATE (MMfDDDM LIMITS GENERAL LIABILITY PHPK402056 04/04/2009 04/04/2010 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED ce)$ 100,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX1 OCCUR MED EXP (Any one person) $ 15,000 PERSONALBADVINJURY S 1,000,000 A GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: PRODUCTS -COMP/OPAGG $ 1,000,000 POLICY JEC7 LOC AUTOMOBILE LIABILITY ANY AUTO PHPK402056 04/04/2009 I 04/04/2010 COM81NEO SINGLE LIMIT (Ea accident) $ 1,000,000 A ALLOWNEDAUTOS X SCHEDU LEI) AUTOS X HIREDAUTOS X NON -OWNED AUTOS 4oTS3011V .� ,f. 1( - fiQO�tt.> ) TCIC'.1SISS`� gil' •7"I BODILY INJURY (Per person) $ BODILYINJURY (Pereocident) $ '60PERTY DAMAGE (Peraceident) $ �� y�� �+tt L�t d GARAGE LIABILITY AUTO ONLY- FA ACCIDENT $ OTHER THAN EAACC AUTOONLY: AGG S ANYAUTO $ EXCESSfUM BRELLA LIABILITY PHUB267256 04/04/2009 04/04/2010 EACH OCCURRENCE $ 5,000,000 X OCCUR CLAIMS MADE AGGREGATE S 5,000,000 $ A S DEDUCTIBLE X RETENTION $ 10,0()0 $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYE $ If yes, describe under SPECIAL PROVISIONS beluv I I I E.L. DISEASE -POLICY LIMIT 1 $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS ]VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS ity of Santa Ana, its officers, agents, employees, and volunteers are additional insureds as per form I-NP-003 (9/03) Item M - Funding Source and Primary Insurance as per form CG00 01 1207, both attached to the general liability policy and accompanying this certificate. *Except for 10 days written notice of cancellation for non-payment of premium. HIS CERTIFICATE REPLACES & RESCINDS PRIOR CERT ISSUED 04/03/09. City of Santa Ana - CDBG M-25 ESG Attn: Frank Hernandez P.O. Box 1988 M-25 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Ellie Liu, CISR/EL1 ACORD 25 (2001I08) FAX: (714) 647-6549 ©ACORD CORPORATION 1981