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OP ID: LC
<br />^'"' CERTIFICATE OF LIABILITY INSURANCE
<br />°AT06/24114 Y)
<br />06/24114
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such andorsament(s).
<br />PRODUCER626.943.2200
<br />Narver Insurance
<br />641 W. Las Tunas Drive 626.299.1070
<br />PO Box 1509
<br />San Gabriel, CA 91776
<br />Robert Molinarogg
<br />CONTACT Ryan Wood
<br />f l N.e.t4626.943.2213 _ _ _11 FAX L Nor 626.299.1010
<br />-" _ - --
<br />E-MAIL
<br />ADDRESS: rwood@narver.com
<br />PROTOCERKIDWO.1
<br />_
<br />INSURERS) AFFORDING COVERAGE
<br />NAIC 0
<br />_
<br />INSURED Corpor ks Community Development
<br />Corporacion
<br />1902 West Chestnut Avenue
<br />._— ___ ------
<br />INSURERA:PMletleiphla lntlemnity ins.
<br />--..
<br />1$056
<br />INSURER 3: Everest National Insurance Co.
<br />10120
<br />INSURER c:
<br />$ 1,000,000
<br />Santa Ana, CA 92703.4304
<br />_
<br />INsuaOan:
<br />X
<br />_
<br />_INSURER E:
<br />01/07/14
<br />07/07115
<br />INSURER P
<br />$ 100,000
<br />_51000
<br />PERSONAL S ADV INJURY-
<br />COVERAGES CERTIFICATE Nt1MRFR• .. iso oro.
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED -ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />ILTH
<br />TYPE OF INSURANCE -
<br />NA
<br />SUB
<br />POLICY NU MBER
<br />VMMOIOVn E^%YY
<br />M01I0 YxP
<br />LIMITS
<br />GENERAL LIABILITY
<br />OCCURRENCE
<br />$ 1,000,000
<br />A
<br />X ,COMMERCIAL GENERAL LIABILITY
<br />I-v—n�
<br />CIAIMS-MADL�E OCCUR
<br />4---� —
<br />X
<br />PNPKM120969
<br />01/07/14
<br />07/07115
<br />IyEACH
<br />PREMISES (Ea occurrence)
<br />MED EXP (My one Person)
<br />$ 100,000
<br />_51000
<br />PERSONAL S ADV INJURY-
<br />$ 1,000,000
<br />GENERAL AGGREGATE
<br />$ 3,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />X POLICY PRO- IECT 1-1LOC
<br />PRODUCTS - COMP/OP AGS
<br />$ 3,000,000
<br />j----
<br />$
<br />A
<br />A
<br />AUTOMOBILE
<br />X
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />ALLOWNEDAUTOS
<br />SCHEDULED AUTOS
<br />HIREDAUTOS
<br />PHPK1120969
<br />PHPK1120959
<br />01107/14
<br />I
<br />01/07114
<br />01107115
<br />01/07115
<br />COMBINED SINGLE LIMIT
<br />(Eaaceidep0
<br />$ 1,000+000
<br />BODILY INJURY (Per parson)
<br />$
<br />BODILY INJURY (Per accident)
<br />..
<br />$
<br />R-0 ]7E
<br />PROPERTY DAMAGE
<br />(Per accident)
<br />A
<br />IX
<br />NON.OWNEOAUTOS
<br />PHPK1120969
<br />01107/1$
<br />01/01/15
<br />_I
<br />UMBRELLA LIAO
<br />X
<br />OCCUR
<br />i
<br />EACH OCCURRENCE
<br />$ 1,000,00
<br />A
<br />EXCESS LIAB
<br />-
<br />CLAIMS -MADE
<br />PHUB446716
<br />01/07114
<br />01107115
<br />AGGREGATE
<br />1,000,000
<br />I�X
<br />DEDUCTIBLE
<br />_
<br />$
<br />1
<br />RETENTION $
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETORIPARTNER/EXECUTIVE YIN
<br />OFFICER/MEMBER EXCLUDED? �N)A
<br />(Mandatory In NH)
<br />Dribe under
<br />yyes, desc
<br />ESCRIPTIONOF OPERATIONS below
<br />CAMM01➢53141
<br />02101114
<br />02101115
<br />CSTATU- OTH-'
<br />X I TORYT ITS
<br />EL EACH ACC (DENT
<br />$ 1,000,00
<br />EL. DISEASE -EA EMPLOYE
<br />_
<br />1,6o0,000
<br />E.L. DISEASE - POLICY LIMIT
<br />_$
<br />$ 1,000,000
<br />A
<br />Professional
<br />iPHPK1120959
<br />01107114
<br />01/07/15
<br />Pe laim 1,000,000
<br />Liability„�A
<br />�
<br />Ag eget tc1Y• 3,000.,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORDIOI,Add111onal Remarks Schedule,ifmoraspnccls tlulr
<br />Certificate Holder qutomatically covered as additional insured pe
<br />Endorsement #pI-GLD-HS (10/11), "2 E.” attached.
<br />In the event of non-payment of premium, ten (10) days written no wil e
<br />given prior to cancellation.,4A R -an�oval ey
<br />CITSA-1
<br />City of Santa Ana
<br />City of Santa Ana -Work Center
<br />Julie Castro -Cardenas
<br />1000 E. Santa Ana Blvd., #200
<br />Santa Ana, CA 92701
<br />SHOULD ANY THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIR N DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANC WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />(cc) 1gRa.2nne ACnRn CnRPnRATInN All etnHle menn."w
<br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD
<br />
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