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r - - <br />ACORQ CERTIFICATE OF LIABILITY INSURANCE i oi?o`Y i <br />PRODUCER 310.393.9477 FAX 310.393.7186 <br />White & Company Insurance Inc. <br />P 0 Box 70 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Santa Monica, CA 90406-0070 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED Women's Transitional Living Center INSURERA: Philadelphia Ins Co <br />PO Box 6103 INSURERS: <br />Orange, CA 92863 INSURER C: <br /> INSURER D: <br /> INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR D' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br /> GENERAL LIABILITY PHPK849367 04/04/2012 04/04/2013 EACH OCCURRENCE $ 1,000,0001 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED = 1,000,0001 <br /> CLAIMS MADE 7 OCCUR MED EXP (Any one person) t 20,00 <br />A PERSONAL & ADV INJURY S 1,000 <br />00 <br /> GENERAL AGGREGATE , <br />$ 2 000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER. <br />O <br />P PRODUCTS - COMP/OP AGG $ 1,000,00 <br /> R <br />- <br />POLICY <br />JECT LOC <br /> AUTOMOBILE LIABILITY PHPK849367 04/04/2012 04/04/2013 <br /> COMBINED SINGLE LIMIT <br />S <br /> ANY AUTO (Es accident) 1-'0_0_0'O00 <br /> ALL OWNED AUTOS <br />BODILY INJURY <br /> <br />A <br />X <br />SCHEDULED AUTOS <br />(Per person) : <br /> X HIRED AUTOS <br />BODILY INJURY <br /> <br />X <br />NON <br />TO <br />OWN <br />(Per accident) s <br /> ED AU <br />S <br />- <br /> PROPERTY DAMAGE <br /> S <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S <br /> ANY AUTO EA ACC <br />OTHERTHAN S <br /> AUTO ONLY. AGG S <br /> EXCESSAUNBRELLALIABILITY PHUB379699 04/04/2012 04/04/2013 EACH OCCURRENCE $ 5 000 00 <br /> OCCUR FICLAIMS MADE AGGREGATE S 5 , 000 00 <br />A <br /> $ <br /> DEDUCTIBLE <br />$ <br /> X RETENTION s 10,00 b <br /> WORKERS COMPENSATION AND WC STATU- OTH- <br />I I <br /> EMPLOYERS' LIABILITY JeA _' <br />FR <br /> ANY PROPRIETORlPARTNERIEXECUTIVE E.L. EACH ACCIDENT $ <br /> OFFICERIMEMBEREXCLUDED? <br />If yes <br />describe under E.L. DISEASE - EA EMPLOYE S <br /> , <br />SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ <br /> OTHER <br />DESCRIPTI OF OPERATIONS I LOCATIONS I HICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />it <br />ot?Santa Ana <br />its office <br />t <br />l <br />y <br />, <br />rs, agen <br />s, emp <br />oyees, and volunteers are additional insureds as per form <br />G 20 26 07 04 and Primary Insurance as per form CG00 01 1207, both attached to the general liability <br />policy and accompanying this certificate. <br />Except for 10 days written notice of cancellation for non-payment of premium. <br />City of Santa Ana - CDBG M-25 <br />ESG <br />Attn: Frank Hernandez <br />P.O. Box 1988 M-25 <br />Santa Ana, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />30* DAYS wRLTTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />BUT FAILURE TO MAIL SUCH NOTICE SNALL IMPOSE NO OBLIGATION OR LIABILITY <br />OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br />ACORD 251)2001/08) FAX: 714.647.6549 0AC0RQWdN1tP0RAT1nN 1988 <br />`-ZaRCK <br />__J?g LIS <br />q E. <br />?/ <br />Assistant City Attorney