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ACORD,M CERTIFICATE OF <br />LIABILITY INSURANCEDATE(MmmorYYYY) <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />05/17/2013 <br />PRODUCER (949) 218-0840 <br />Global Program Managers & Ins. Srvcs., <br />Post Office Box 7119 <br />Capistrano Beach CA 92624-7119 <br />Inc. <br />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 />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURED <br />KidWorks Community Development Corporation <br />1902 West Chestnut Avenue <br />Santa Ana CA 92703- <br />INSURER A. PHILADELPHIA INDEMNITY 18058 <br />msURERB.EVEREST NATIONAL <br />10120 <br />UN nRC. <br />INSURER D. <br />/ / <br />INSURER E'. <br />ItleYIAM-114I <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />ADD -L <br />INSRD <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MMIDDIYY <br />POLICY EXPIRATION <br />DATE MMIDDIYY <br />LIMITS <br />A <br />GENERAL LIABILITY <br />/ / <br />/ / <br />EACH OCCURRENCE $ 1,000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE OCCUR <br />/ / <br />/ / <br />DAMAGETO RENTED )00,000 <br />PREMISES Ea occurrence) $ <br />MED EXP (Any one person) $ 5,000 <br />PERSONAL B ADV INJURY $ 1,000,000 <br />GENERAL AGGREGATE $ 3,000,000 <br />PHPK 957 375 <br />01/07/2013 <br />01/07/2014 <br />GEN'L AGGREGATE LIMIT APPLIES PER. <br />X POLICYJET F7 LOC <br />PRODUCTS - COMPIOP AGG $ 3,000,000 <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />/ / <br />/ / <br />COMBINED SINGLE LIMIT $ 1,000,000 <br />Ida accident) <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />/ / <br />/ / <br />BODILY INJURY <br />(Per person) $ <br />X <br />X <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PHPK 957 375 <br />01/07/2013 <br />01/07/2014 <br />BODILY INJURY <br />(Per accident) $ <br />PROPERTY DAMAGE <br />(Per accident) $ <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />ANY AUTO <br />/ / <br />/ / <br />OTHER THAN EA ACC $ <br />AUTO ONLY. AGO $ <br />EXCESSIIIMBRELLA LIABILITY <br />/ / <br />/ / <br />EACH OCCURRENCE S <br />AGGREGATE 3 <br />OCCUR F] CLAIMS MADE <br />4 <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />B <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />5900001267-131 <br />02/01/2013 <br />02/01/2014 <br />WCSTATU- OTH- <br />X I TORY LIMITS I I ER <br />E. L. EACH ACCIDENT $ 1,000,000 <br />ANY PROPRIETORIPARTNERiEXECUTIVE <br />OFFICER MEMBER EXCLUDED? <br />If yes, describe under <br />EL DISEASE -EA EMPLOYEE 1,000,000 <br />E.L. DISEASEPOLICYLIMIT $ 1,000,000 <br />SPECIAL PROVISIONS below <br />OTHER <br />A <br />PROFESSIONAL LIAR <br />PHPX 957 375 <br />01/07/2013 <br />01/07/2014 <br />EACH INCIDENT $1,000,000 <br />POLICY AGGREGATE $1,000,000 <br />DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br />RE: CITY OF SANTA ANA YOUTH COUNCIL WORKFORCE CONTRACT <br />CITY OF SANTA ANA NAMED AS ADDITIONAL INSURED PER ATTACHED SPECIAL ENDORSEMENT <br />IN THE EVENT OF NON-PAYMENT OF PREMIUM, ONLY TEN (10) DAYS NOTICE WILL BE GIVEN. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />030 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br />SANTA ANA YOUTH COUNCIL WORKFORCE FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br />INVESTMENT BOARD INSURER, ITS AGENTS OR REPRESENTATIVES. <br />1000 E. Santa Ana Blvd., #200 AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92701- 9IJ'--__ <br />ACORD 25 (2001108) - _ A8A'(V0OftAkPFATION1988 <br />INS025(0108).01 ELECTRONIC LASER FORMS INC -(a00)32T-0545, I�-�/ r' A, _ Page 1of2 <br />Assistcnnt City AtiOrney <br />/1i <br />