MERCY HOUSE LIVING CENTERS (ESG 2010) (2)

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CERTIFICATE OF LIABILITY INSURANCE OP ID PC DATE(MMND/YYYY) ANY REQUIREMENT, TERM OR CONDITON OF ANYCONTRACT OR OTHER DOCUME14T WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MERCY -2 07/01/10 PRODUCER LTR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Chapman POLICYNUMSER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License 10522024 LIMITS HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. 0. Box 5455 GENERAL LIABILRY ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Pasadena CA 91117 -0455 EACH OCCURRENCE S 1,000,000 Phones 626 -405 -8031 Fax s 626 -405 -0585 X INSURERS AFFORDING COVERAGE NAIC N INSURED 05/02/11 INSURERA: Philadelphia Insurance company 23850 MED EXP (Any one person) $ 5,000 INSURER B: Everest National - 10120 Mercy Hou Q T ?05 -....---- ....... INSURER C: - -. P.O. Box Santa Ana CA 92702 D., INSURER D: GENERALAG13REGATE S 2 f 000, 000 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAAIED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITON OF ANYCONTRACT OR OTHER DOCUME14T WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED SY PAID CLAIMS. LTR SRQ TYPE OF INSURANCE POLICYNUMSER DATE D D LI M ADD LIMITS GENERAL LIABILRY EACH OCCURRENCE S 1,000,000 A X X COMMERCIAL GENERAL UABILTTY CLAIMS MADE X❑ OCCUR PHPK562497 05/02/10 05/02/11 PREMISES eoccurence S 100r000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 _ GENERALAG13REGATE S 2 f 000, 000 GEN'I AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OPAGG 52,000,000 POLICY PRO, LOO JECT — —' A AUTOMOBILE X LIABARY ANY AUTO PHPK562497 *.%02'/10 0 /02/11 COMBINED SINGLE LIMIT (Ea accident) $1000000 ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON•OW14EDAUTOS QgO air S'C�a S C'M p` ey -- s BODILY INJURY (Par parson) BODILY INJURY (Peraccident) S to A59� PROPERTY DAMAGE (Per ecddenq $ GARAGE LIABILITY AUTO ONLY • EA ACCIDENT $ ANY AUTO EA ACC OTHER THAN ___. AUTO ONLY: AGO $ $ A EXCESSI UMBRELLA LIABILITY X OCCUR CLAIMS MADE PHUB305872 05/02/10 05/02/11 EACH OCCURRENCE $1000000 AGGREGATE _ S1000000 DEDUCTIBLE 0 $ X RETENTION $10000 S $ WORKERS COMPENSATION AND EMPLOYERS' LIABILIT Y ANY PROPRIETOFUPARTNERIEXECUTIV4Y�� OFFICERIMEMBER EXCLUDE I? L_ I (Mandatory In NH) If yes, describe under SPECIAL PROVISIONS below 6600000730091 10/01/09 10/01/10 X TORY LIMIT S E.L.EACHACCIDENT __...._._.__._..__..__ $ 000000 E.L. DISEASE - EA EMPLOYEE $1000000 E.L. DISEASE -POLICY LIMIT $1000000 OTHER A D &O PHSD454501 10/17/09 10/17/10 Limit 1000000 Dad. 2500 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES( EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS Re: CDBO, ESO, 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 ACORD 25 (2009/01) 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 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. I7I Fx The ACORD name and logo are registered marks of ACORD All rinhis reserved