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ACORD CERTIFICATE OF <br />LIABILITY <br />INSURANCE <br />TYPE OF INSURANCE <br />DATE28 /2014 <br />03/28/2014 <br />PRODUCER (949) 218 -0840 <br />NARVER INSURANCE <br />641 W. LAS TUNAS DRIVE <br />SAN GABRIEL CA 91776 -7119 <br />POLICY EXPIRATION <br />DATE MM/DDM' <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 />X <br />NAIL# <br />INSURED <br />KidWorks Community Development Corporation <br />1902 West Chestnut Avenue <br />Santa Ana CA 92703- <br />INSURERA: PHILADELPHIA INDEMNITY <br />18058 <br />INSURER B: EVEREST NATIONAL <br />$ 11000,000 <br />10120 <br />INSURER C: <br />MED EXP(Any one person <br />$ 5,000 <br />INSURER D: <br />$ 1,000,000 <br />INSURER E: <br />rnvaanr.Pc <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 />POLICYNUMBER <br />POLICY EFFECTIVE <br />DATE MMIDOM' <br />POLICY EXPIRATION <br />DATE MM/DDM' <br />LIMITS <br />A <br />X <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE OCCUR <br />PHPK 1120959 <br />/ / <br />/ / <br />01/07/2014 <br />/ / <br />/ / <br />01/07/2015 <br />EACH OCCURRENCE <br />$ 11000,000 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />$ 100,000 <br />MED EXP(Any one person <br />$ 5,000 <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 3,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />X POLICY JECOT LOG <br />PRODUCTS - COMPIOP AGG <br />$ 3,000,000 <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PHPK 1120959 <br />/ / <br />/ / <br />01/07/2014 <br />/ / <br />/ / <br />01/07/2015 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ 1,000,000 <br />BODILY INJURY <br />(Per person) <br />$ <br />• <br />BODILY INJURY <br />(Per accident) <br />$ <br />• <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />GARAGE LIABILITY <br />ANY AUTO <br />/ / <br />/ / <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHER THAN EA ACC <br />AUTO ONLY: AGO <br />$ <br />$ <br />EXCESS /UMBRELLA LIABILITY <br />OCCUR FI CLAIMS MADE <br />DEDUCTIBLE <br />RETENTION $ <br />/ / <br />/ / <br />/ / <br />/ / <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />$ <br />$ <br />B <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />ANY PROPRMTORJPARTNERJEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />CA10001753141 <br />02/01/2014 <br />/ / <br />02/01/2015 <br />/ / <br />X I TORVLIMITE OER <br />E.L. EACH ACCIDENT <br />$ 11000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 11000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$ 11000,000 <br />A <br />OTHER <br />PROFESSIONAL LIAR <br />PHPK 1120959 <br />01/07/20 <br />_EACH INCIDENT $1,000,000 <br />od H $1,000,000 <br />DESCRIPTION OF OPERATIONS /LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT /SPECIA RO <br />AE: DIA de Iona NINOS CELEBRATION BEING HELD ON APRIL 12, 2014 <br />CITY OF SANTA ANA NAMED AS ADDITIONAL INSURED PER ATTACHED SPECI E ASEP$'�a <br />IN THE EVENT OF NON - PAYMENT OF PREMIUM, TEN (10) DAYS WRITTEN N j�V SLUanNt F4SORr1TO CANCELLATION. <br />U. —it <br />CITY OF SANTA ANA <br />ATTN: RISK MANAGEMENT <br />20 CIVIC CENTER PLAZA <br />Santa Ana CA 92704- <br />11 25 1200110 81 <br />ftT, INS025(010i <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 />FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br />AUTHORIZED REPRESENTATIVE <br />ELECTRONIC LASER FORMS, INC. - (800)327 -0545 <br />'ra13Rtl:LiR�1 r13�Te7,r iLTXLGiITE <br />Pagel of 2 <br />