ORANGE COUNTY CHILDREN'S THERAPEUTIC ARTS CENTER 18 - 2012

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o DATE (MMIDDIYYYY) ORD AC,,, CERTIFICAT�' 7F LIABILITY INSURAN "E 01/13/2012 PRODUCER 714.838.1912 FAX 714.338.7568 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Lake Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 653 South B Street, Suite 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lic #0747473 INSURERS AFFORDING COVERAGE NAIC # Tustin, CA 92780 INSURED Orange County Children's Therapeutic Art Center INSURERA: Philadelphia Insurance Co. 2215 N. Broadway INSURER B: Santa Ana, CA 92706 INSURER C: INSURER D: INSURER E: COVERAGES THE ANY MAY POLICIES. INSR INSR POLICIES OF INSURANCE LISTED BELOW REQUIREMENT, TERM OR CONDITION PERTAIN, THE INSURANCE AFFORDED AGGREGATE LIMITS SHOWN MAY DD' TYPE OF INSURANCE GENERAL LIABILITY HAVE BEEN ISSUED TO THE INSURED OF ANY CONTRACT OR OTHER DOCUMENT BY THE POLICIES DESCRIBED HEREIN HAVE BEEN REDUCED BY PAID POLICY NUMBER PHPK794249 NAMED ABOVE WITH RESPECT IS SUBJECT CLAIMS. POLICYEFFECTIVE 12/21/2011 FOR THE POLICY TO WHICH TO ALL THE TERMS, POLICY EXPIRATION D 12/21/2012 PERIOD INDICATED. NOTWITHSTANDING THIS CERTIFICATE MAY BE ISSUED OR EXCLUSIONS AND CONDITIONS OF SUCH LIMITS EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 100,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE � OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 A GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGG $ 2 , 000 , OOO GEN'L AGGREGATE LIMIT APPLIES PER: T X LOC POLICY jE� AUTOMOBILE LIABILITY PHP K794249 12/21/2011 12/21/2012 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ A SCHEDULED AUTOS X HIREDAUTOS rX AST 'v �� BODILY INJURY (Per accident) $ NON -OWNED AUTOS _ ^� ROvV iQr{+ `OR � ` p`t �I S �t City �SSIS {, a ,L `` O PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT $ $ GARAGE LIABILITY ANY AUTO EA ACC OTHER THAN AUTO ONLY: AGG $ $ EACH OCCURRENCE $ EXCESSIUMBRELLA LIABILITY OCCUR FI CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ _ _ _ __ _ WC STATU- OTH- WORKERS COMPENSATION AND EMPLOYERS' LIABILITY E.L. EACH ACCIDENT _ $ E.L DISEASE - EA EMPLOYEE $ ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under - SPECIAL PROVISIONS below E.L. DISEASE- POLICY LIMIT $ PHPK794249 12/21/2011 12/21/2012 Incident Limit: $1,000,000. Aggregate Limit: $2,000,000 OTH Professional Liability A DESCRIPTION Certificate Abuse This OF OPERATIONS I LOCATIONS 1 VEHICLES Holder is Named as & Molestation is included Insurance Shall be Primary I EXCLUSIONS ADDED BY ENDORSEMENT Additional Insured per with General Liability and Non- Contributory I SPECIAL PROVISIONS Form CG 20 , $25,000 but Only in 26.07 04 Attached Each Incident the Event ► and $50,000 Aggregate of the Named nsured's *Except Sole Negligence per 10 Days Notice of Cancellation Attached Endorsement for Non - Payment of Premium ICATE HOLDER ^'" "" SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE The City of Santa Ana EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Its officers, Employees, Agents, Volunteers *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, and Representatives - WIA BUT FAILURETOMAILSUCHNOTICE HALL IMPOSE MO-.06LIGATION�ORLIABILITY Attn: Julie Castro - Cardenas 1000 E Santa Ana Blvd #200 OF ANY KIND UPON THE INSURER, 1 S NTSJOR R PR AT ES, Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) FAX: 714.565.2602 ©ACORD CORPORATION 1908 .