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RORU O® CERTIFICATE OF LIABILITY INSURANCE OP ID PC DATE(tSMJDDJYYYY MERCY-2 07/01/10 R THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Chapman ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License f0522024 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:626-405-0585 INSURERS AFFORDING COVERAGE NAIC N INSURED INSURER A: Philadelphia insurance company 23850 INSURERS: Everest National 10120 Mercy House INSURERC: P.O. Box 1905 INSURER D: Santa Ana CA 92702 I I INSURER E; COVERAGES TOE POLICIES OF INSURANCE LISTED BELOW HAVE BEEIJ ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDTNG ANY REOUIREMENT, TERM OR CONDITIONOFANY CONTRACT OR OTHER OOCUIMENTWITH 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 MAYHAVE BEEN REDUCED BY PAID CLAMS. LTR NSR TYPE OFINSURAIlCE POLICY NUMBER AT dMDD Pp PP DA lME1D LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 A X X coh1RIERCIALGEtIERALLNBILrTY CLAIMS )MADE X� OCCUR PHPK562497 05/02/10 05/02/11 PREMISES soccurence S 100 000 µED EXP (Any one person) $ 5,000 PERSONAL& ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE N L AGGREGATE LWIT APPLIES PER: PRODUCTS-COMPIOPAGG $ 2,000,000 POLICY JEST LOC A AUTOMOBILE X LLABILTTY ANY AUTO PHPK562497 ��+({�� 0&go2i/i0 0 /0 /ll COMBINED SINGLELIMIT (Eaaccidenl) $ 1000000 ALL OWNED AUTOS SCHEDULED AUTOS HIREOAUTOS NON -OWNED AUTOS �y A®�( 4^" �551 A S, ��ORt T^ C1i��l to n 7 rng� BODILYINJURY (Per person) $ BODILYIIJURY (Perecddent) $ PROPERTY DAMAGE (Per eccldenq $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANYAUTO OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESS/ UMBRELLA LIABILITY X I OCCUR CLAIMSMADE PHUB305872 05/02/10 05/02/11 EACH OCCURRENCE $ 1000000 AGGREGATE $ 1000000 3 DEDUCTIBLE $ X RETENTION $10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILR ANFICER1hEPRO IMBEREXCTnEP4E ECUTIVEL (MendaloryInNO) u-1 N yes, ductibe under SPECIAL PROVISIONS below 6600000730091 10/01/09 10/01/10 X TORY LIRIITS ERY _ E.L. EACH ACCIOENT $ 1000000 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 bed. 2500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS 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. 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 DAYSWRRTEN 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. AUTHOR DIED REPRESENTATIVE 01988.2009 ACORD The ACORD name and logo are registered marks otACORD reserved.