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?Jd2rn- L.. C/?7 ??) <br />ACORD„ CERTIFICATE OF LIABILITY INSURANCE iojo3%zoi' <br />PRODUCER X714) 838-1912 FAX 0714)838-7$68 <br />Laice Insurance Agency ? <br />13891 New ort Ave. , Suite 28$ <br />P THIS CERTIFICATE f3 ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NO7 AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Lic #0747473 <br />Tustin, CA 92780 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED Oral)ge County C dren s T erapeutic Art Cente INSURERA phi7adelphia Insurance Co. <br />221$ N. Broadway INS VRER B: <br />Santa Ana , CA 92706 INSURER C: <br />' INSURER D: <br /> INSURER E: <br />??, <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W)TH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />ANY REQUIREPAENT <br />, <br />A1AY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESGRIBEO HERE)N IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />i 15R DD' TYPE OF INSURANCE POLICY NULABER POLICY EFFECTIVE POLICY EXPIRATION LIIAITS <br /> GENERAL LIABILITY PHPK651S22 12/21/2010 12/21/2011 EACH OCCURRENCE $ 1,000 000 <br /> X COIAMERCIALGENERALIfABILnY DAAV\GETORENTED S ZOO OOO <br /> CLAIAIS MADE ? OCCUR IAED EXP (Any one pa,son) $ $ 000 <br />A PERSONAL 3ADV INJURY S 1, OOO OOO <br /> GEN ERAL AGGREGATE S 2 QQQ QQQ <br /> GEN'L AGGREGATE U/AIT APPLIES PER: PRODUCTS - C01.1P/OP AGG S 2 OOO OOO <br /> POLICY PRO LOG <br />JEGT <br /> AU FOltOBILE LIABILITY PHPK651522 12/21/2Q1O 12/21/2011 C01.1BINE0 SINGLE LEAIT <br />S <br /> ANYAVTO - (ES acc7denq I OOO QQQ <br /> ALL OWNED AUTOS BODiIY INJURY <br />`?' <br /> SCHEDULED AUTOS lPar pararn) <br />A <br /> X HIRED AUTOS <br />BDDILY INJURY <br />S <br /> X NON-OWNED AUTOS ? (Per accWenl) <br /> ? <br /> ?© PROPERTY DAMAGE S <br /> ?® (Per acddenp <br /> DARAOE LIABILITY ={'? AUTO ONLY-EA ACCIDENT S <br /> .ANY AD70 ///??? <br />y????®'V ? EA ACC <br />OTHER THAN S <br /> Ci C? AUTO ONLY. <br /> ? O R AOO S <br /> EXCESS/UMBRELLA LIABILITY gP <br />• Ptt.O EACH OCCURRENCE S <br /> ? <br />` t?? <br /> OCCUR Q CLAIMS RV?DE to t <br />? AGGREGATE S <br /> 1??- <br />.f?"'?j\S 1 <br />f <br />5 <br /> DEDUC77BLE S <br /> RETENTION 5 <br />S <br /> WORKERS COMPENSATION AND WC STATU- OTH- <br /> EI.IPLOYERS• LIABILITY E-L. EACH ACCIDENT S <br /> ANY PROPRIETOR/PARTNER/EXECUTNE <br />OFFICER/MEMBER EXCLU DEG? <br />EL DISEASE - EA EMPLOYEE <br />S _ <br /> I(Yyes, tlescr?be under <br />SPECIAL PROVISIONS Eeiow <br />E. L. DISEASE-POLICY LIAt17 <br />S <br /> Pi^o? <br />l Li <br />bilit <br />i PHPK6S1S22 12/21/2010 12/21/2011 Incident Lin)it: $1,000,000 <br />A ona <br />ess <br />y <br />a Aggregate Limit: $2,000,000 <br />DESCRIP IOIJ OF OPERA 10)J3 / LOCATI01i91 VEIfICLE91 EXCLU310113 ADDED BY ENDO 3EL1EN7} SPECIAL PROVISIONS <br />? <br />; <br />? <br />orm CG 20 26 07 04 Attached <br />ertyt <br />der is AaditTOnal Insured as per <br />icate ho <br />buss & hlolestation is included with General Liability 525,000 Each Incident and $50,000 Aggregate <br />his Insurance Shall be Prin)ary and Non-Contributory but Only in the Event of the Nalned <br />nsured's Sole Negligence per attached endorsement <br />•Except 10 Days Notice of Cancellation for Non-Payment of Premium <br />c c <br />SHOULD ANY OF THE ABOVB DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />city of Santa Ana Police Athl eti cs EXPIRATION DATE THEREOF. THE ISSUIN(31NSURER WILL ENDEAVOR TO MAIL ' <br />and Activities League, Its Offi cers Elnpl oyes yr3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER IlAh1ED TO THE LEFT, <br />Agents Volunteers & Representatives <br />Attn: Tom Serafin BUT FAILURE T01.1AIL SUCH NOTIC€1 SHALL IIJPOBB NO OBLIGATION OR LIABILITY <br />2627 West Dic Fadden Street OF ANY KING UPON THEINSURER ITS ENT90R EP NT VES. <br />Santa Ana, CA 92704 AVTHOR2ED REPRESENTATIVE - <br />ACO RD 26 (2001/08) ®ACORD CORPORATION 1988