MERCY HOUSE LIVING CENTERS (ESG 2010a)

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coRtS CERTIFICATE OF LIABILITY INSURANCE OP ID PC DATE (14001" ANY REQUIREMENT, TERM OR CONDITOn OF ANYCONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MERCY -2 07/01/10 PRODUCER INS THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION Chapman __- ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License $0522024 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. O. BOX 5455 TYPE OF INSURANCE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Pasadena CA 91117 -0455 LIMITS Phone: 626- 405 -8031 Fax t 626 -405 -0585 GENERAL LIABILITY INSURERS AFFORDING COVERAGE NAIC N INSURED CURRENCE INSURER A: Philadelphia Inenremoe company 23850 X X COMMERCIAL GENERAL LIABILITY INSURER B: Everest National 10120 Mercy HOu Q PREMISE aoavrance INSURER C: -- . P.O. BOX 9 05 Santa Ana CA 92702 CLAIMS MADE X] OCCUR ^.. INSURER D: 1_ __ (Any one person) INSURER E: AL E ADV INJURY 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 CONDITOn OF ANYCONTRACT 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. INS __- LT SR TYPE OF INSURANCE POLICYNUMSER DATE D LIMITS GENERAL LIABILITY 770S CURRENCE S1,000,000 A X X COMMERCIAL GENERAL LIABILITY PHPK562497 05/02/10 PREMISE aoavrance S100,000 CLAIMS MADE X] OCCUR (Any one person) $ 5 000 AL E ADV INJURY $1,000,000 GENERAL AGGREGATE $2!000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS •COMP/OPAGO 4210001000 POLICY p JE PRCT O• LOC — AUTOMOBILE LIABILITY ��L�('}} COMBINED SINGLE LIMIT $ 1000000 A X AHYAUro PHPK562497 0 0P0 0 /0 /11 (Ea accident) ALL OWNED AUTOS 4* V ^ �iQO S� - BODILY INJURY $ SCHEDULED AUTOS HIRED AUTOS a {Pet person) NON OWNED AUTOS 4 ,A � CAI in 0y BODILYINJURY (Per acddenl) $ tan PROPERTY DAMAGE — _,_......_— ..._._ S A59� (Per acddenl) GARAGE LIABILITY AUTO ONLY • EA ACCIDENT S ANY AUTO EA ACC OTHER THAN __... $ $ AUTO ONLY: AGO EXCESS/ UMBRELLA LIABILITY EACH OCCURRENCE S1000000 A X OCCUR L.� CLAIMSMADE PHUB305872 05/02/10 05/02/11 AGGREGATE _ $ 1000000 DEDUCTIBLE $ X RETENTION $ 10000 S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X TORY LIMBS ER B ANY PROPRIETORJPARTNERIEXECUTIVFjY /-Nj OFFICERpdEMSEREXCLUDED7 LJ 6600000730091 10/01/09 10/01/10 E.L.FACHACCIDENT $ 1000000 E.L. DISEASE • EA EMPLOYEE $1000000 (Mendalory in NH) If yes, descilbs under E.L. DISEASE•POLICYLIMIT IS 1000000 SPECIAL PROVISIONS below OTHER A D &O PHSD454501 10/17/09 10/17/10 Limit 1000000 j I Ded. 2500 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS Re: CDBG, ES0, 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. 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 (2009/01) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CTTYSAN DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO NAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, 1988 -2009 The ACORD name and logo are registered marks of ACORD All rights reserved.