MERCY HOUSE LIVING CENTERS (ESG 2010)

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.�CORO CERTIFICATE OF LIABILITY INSURANCE OP ID PC UAIr tmwuu TTTT) 1 � MERCY -2 07/01/10 PRODUCER H Lip LTR SR D TYPE OF INSURANCE POLICYNUMBER DATE D TE M ND LIMITS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Chapman GENERAL LIABILITY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License #0522024 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. O. Box 5455 A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Pasadena CA 91117 -0455 PHPK562497 05/02/10 05/02/11 Phone: 626 -405 -8031 Fax:626- 405 -0585 S 100r000 INSURERS AFFORDING COVERAGE NAIC INSURED $ 1,000,000 INSURER A: Philadelphia Insurance company 23850 INSURER B: Bverest National 10120 Mercy Hou Q 1905 INSURER C: - _.. —.._ ...—. s2,000,000 P.O. Box Santa Ana CA 92702 INSURER D: I GE NT. AGOREGATE LIMIT APPLIES PER: 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 MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONCITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. H Lip LTR SR D TYPE OF INSURANCE POLICYNUMBER DATE D TE M ND LIMITS GENERAL LIABILITY EACH OCCURRENCE S1,000,000 A X X COMMERCIAL GENERAL LIABILITY CLAIMS MADE I OCCUR PHPK562497 05/02/10 05/02/11 PREMISES soxurence S 100r000 MED ©(P (Any one poison) s5,000 PERSONAL& ADV INJURY $ 1,000,000 _ GENERAL AGGREGATE s2,000,000 GE NT. AGOREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OPAGG 52,000,000 POLICY JECT LOC - -' A AUTOMOBILE X LIABILITY ANY AUTO PHPK562497 0 02i/I0 0 /02/11 COMBINED SINGLE LIMIT IEaa eldont) $ 1000000 ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON•OWNEDAUTOS �lO V 4 P Att CJ`ty $ BODILY INJURY (Per person) -......-..._..—.._.- BODILY INJURY (Perecddent) $ As9, tart PROPERTY DAMAGE (Peracddeny $ ` - — GARAGE LIABILITY AUTO ONLY. EA ACCIDENT S ANY AUTO EA ACC OTHER THAN __ AUTO ONLY: AGG $ $ A EXCESSIUMBRELLA LIABILITY X OCCUR CLAIMSMADE PHUB305872 05/02/10 05/02/11 EACH OCCURRENCE S 1000000 AGGREGATE _ $ 1000000 H DEDUCTIBLE X RETENTION $ 10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNERIEXECUTIVF��-Nj OFFICERIMEMBER EXCLUDED? (Mandatory ln NH) If ECIAL describe R under SPECIAL PROVISIOlNS below 6600000730091 10/01/09 10 /01 /10 X TORY TAT(J. ERR E.L. EACH ACCIDENT _ _ _ $ 1000000 _ - - E.L. DISEASE • EA EMPLOYEE $ 1000000 E.L. DISEASE - POLICYLIMIT S 1000000 OTHER A D &O PHSD454501 10/17/09 10/17/10 Limit 1000000 Ded. 2500 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIOINS Re: CDBG, ESG, and HPRP 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. worker compensation coverage excluded, evidence only. 10 days notice of cancellation for non - payment of premium. CERTIFICATE HOLDER CANCELLATION ACORD 25 City of Santa Ana Frank Hernandez 20 Civic Center Plaza P.O. Box 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITYSAN 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 $0 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. F The ACORD name and logo are registered marks of ACORD All rinhts roaarvarl