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--- .1 A OP ID: AP CERTIFICATE OF LIABILITY INSURANCE oAT03/08112 (MMIDDIYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements PRODUCER 925-934-8500 NAME CT (WC) Heffernan Insurance Brkrs 925-934-8278 200 it 50 C k A S 1 lb PHONE - A/C No c o E:t: u e ac ve, 3 ar Walnut Creek, CA 94596 ADDRIESS: OC-HOUSE Commercial-Pre Merg PRODUCER WISEPL1 CUSTOMER 10 #: - INSURERS AFFORDING COVERAGE NAIC # INSURED Wiseplace, a Ca Corp INSURER A: Philadelphia Indemnity Ins. Co dba: Wise Silver Center INSURER B: STATE COMPENSATION INS. FUND 35076 1411 N. Broadway INSURER C : Santa Ana, CA 92706 . - INSURER O ; INSURER E INSURER F : rnveeenee CERTIFICATE NUMBER, REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS LTR TYPE OF INSURANCE ADDL INSR SUB POLICY NUMBER MMIDDY EFF MM/DDY EXP _ LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X PHPK653590 01101112 01101113 DAMAGE TO RENTED PREMISES Ea occunence 100 000 $ CLAIMS-MADE FXI OCCUR MED EXP (Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 X Prof. Liability GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIESPER: PRODUCTS - COMPIOP AGG $ 2,000,000 POLICY PRO- LOC AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A X ANY AUTO PHPK653590 01/01112 01101/13 D $ ILY INJURY (Per person) BO ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ X HIREDAUTOS (Per accident) X NON-OWNEDAUTOS $ UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 A PHUS327847 01101112 01101113 DEDUCTIBLE $ X RETENTION $ 10,000 $ WORKERS COMPENSATION ' X WCSTATU- OTH- TORY LI B AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN 488000067909 08/15/11 08115112 E.L. EACH ACCIDENT. $ 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ A C PHPK653590 01101112 01101/13 EDis. 50,000 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project: As on file with the insured. The City of Santa Ana, its officers employees, agents, volunteers and representatives are named as additional insured on General Liability policy per attached endorsement. m. ity of Santa Ana 20 Civic Center Plaza SANTAN4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ti Santa Ana„ CA 92701 AUTHORIZED REPRESENTATIVE o ^ ©1988-2009 CORPORA is•5eserved. e ACORD 25 (2009109) The ACORD name and logo are registered marks of ACQ g ?y ISP A?o?r ? G? L r ?s?a PSS