WOMEN'S TRANSITIONAL LIVING CENTER (WTLC) (2)-2015

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A ®AI CERTIFICATE OF LIABILITY INSURANCE 04/14/2014' PRODUCER 310393.9477 FAX 310.393.7186 White .& Company Insurance Inc.___ __ ° - -' � — P 0 Box 70 Santa Monica, CA 90406 -0070 Sally Austin -- -�— THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE - HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, INSURERS AFFORDING COVERAGE POLICY NUMBER NAIC6 INSURED Women's Transitional Living Center PO BOX 6103 Orange, CA 92863 INSURERA: Philadelphia Ins Co INSURER B: PHPK1156635 04/04/2014 INSURER O: EACH OCCURRENCE $ 1,000,000 INSURER D: X COMMERCIAL GENERAL LIABILITY INSURER e: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSfl LTR ADDA NSA TYPE OF INSURANCE POLICY NUMBER POLOYEFFECTIVE WOO POLICY EXPIRATION LIMITS GENERAL LIABILITY PHPK1156635 04/04/2014 04/04/2015 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO PRINTED $ 1,000,000 CLAIMS MADE OCCUR $ 20,060 .•5,_ncau[eer M50 EXP IAny one person) A PERSONAL &AOV INJURY $ 11600,000 GENERAL AGGREGATE $ 21000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. comp /OP AGO $ 1,000,006 X POLICY PRO• JECT LOS AUTO MOBILE LIABILITY PHPKII56635 04/04/2014 04/04/2015 COMBINED SINGLE LIMIT ANY AUTO (En arridan9 $ 1,000,00 BODILY INJURY $ ALL OWNED AUTOS X SCHEDULED AUTOS - (Per person) A BODILY INJURY $ X HIRED AUTOS X NON-OWNCOAUTO$ (Per=ldroiQ PROPERTY DAMAGE S (Per accidenU GARAGE LIARRJT� r. AUTO ONLY• EA ACCIDENT 5 I I ANY AUTO OTHER THAN EA ACC 5 �.,•,• $ AUTO ONLY: AGG SS/UMBRELLA LIABILITY PHUB455286 04/04/2014 04/04/2015 EACH OCCURRENCE s 5 000 000 OCCUR CLAMS MADE AGGREGATE $ 5,000,000 A EA $ DEDUCTIBLE �q�f" B% $ RETENTION $ 10,00 qp S o FO $ ,..._. WORKERS COMPENSATION AND ORYI MIU OT , Y PR EMPLOYERS LIABILITY ° E.L EACH ACCIDENT 5 ANY PROPRIETOPlPARTNGMXECUnVE OEFICENMEMBEB EXCLUDED? ._ n Il ye s, describe under u n es �'�i1Rv A W IRBY E;L DISEASE- 1A EMPLOYEE 5 E,L.OIBEASE•POLICY LIMIT 9 SPECIAL PROVISIONS bolow ._s CI #y Attt OTHER —• Ea1'V> —`� DESCRIPTION OF OPERATIONS( LOCATIONS I VEHICLES I EXCLUSIONS ADDED B.Y ENDORSEMENTISPECALPROVISIONS ity of Santa Ana, its officers, agents, employees, and volunteers are additional insureds as per form G 20 26 07 04 and Primary Insurance as per form CG 00 01 04 03 both attached to the general liability olicy and accompanying this certificate. *Except for 10 days written notice of cancellation for non - payment of premium. City of Santa Ana - CDBG M -25 ESG Attn: Daniel Perez P.O. Box 1988 M -25 Santa Ana, CA 92702 A rnan efl rannvnnl FAX: 71.4.647.6549 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF-, THE ISSUING INSURER WILL *W1YC7 ft MAIL 30''° DAYS WRITTEN NO "HCETO THE CERTIFICATE HOLDER NAMED TO THE LEFT, XIX MHUXM& ,)(xmM T�xx)wdI.> kkkNXiXmU6X)6xXLtXIYJXXXX AUTHORIZED REPRESENTATIVE IA b` ,OM1 "I "Irr s—n