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ACARD CERTIFICATE OF LIABILITY INSURAN-E 07/27/20 YYYY) _„„ 07/27/2005 PRODUCER Schweickert & Company THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 15 Peters Canyon Road HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Irvine CA 92606 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Mercy House INSURER A. Great American Insurance Company _ P.O. BOX 1905 INSURERS Santa Ana CA 92702 INSURER :OVERAGES 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 CONTRACTOR 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. INM POUCY NUMBER PO41CY EFFECTIVE POIICY EXPIRATION LIMBS X GENERAL LIABILITY X _ COMMERCIAL GENERAL LIABILITY jCLAIMS MADE M OCCUR PAC5373885 � AbUSC Aggregate Aunt iS $1,000,000 05/02/2005 05/02/2006 EACH OCCURRENCEENTED_ EACHOCCUMAGE $_ 1,000,000 TO RENCE $ 100,p00 MED EXP (My one n $ 5,000 PERSONAL AADVINJURY $ 1,000,000 X Profession al Liability No deductible or SIR X Abuse Molestation GENERAL AGGREGATE $ 2,000,000 _& GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 1,000,000 X POLICY PRO- LOG AUTOMOBILE LIABILITY ANYAUTO PAC5373885 05/02/2005 05/02/2006 COMBINED SINGLE LIMIT (Ee aaitlan0 $ 1,000,000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY— (Per Person) A A X X X X HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per awd.e n $ PROPERTY DAMAGE (Per accidenn $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN _ _EA ACC $ AUTO ONLY: AGG $ _EXCEWUMBRELLA LMBKJTY _ OCCUR CLAIMS MADE - 1x�L"L Ise '3r5 # EACH OCCURRENCE AGGREGATE $ _ DEDUCTIBLE r� $ _ $ RETENTION $ �� SLtt Shecdy WORKERS COMPENSATION AND EMPLOYERS'LNBIUTY ANYPROPRIETOR/ARTNEREJ(ECUTIVE yl L City Att Orne WC STAID, OTH- TDRYIIMIT _ E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ OFFICERMEMBER EXCLUDED? B ea deaPRO under V elPw E L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS The City of Santa Ana, its officials, employees, representatives, and volunteers are hereby named as Additional Insureds as respects the operations of or on behalf on Mercy House Transitional Living Center, performed under contract with The City of Santa Ana. ��n i rrrt.n c nvwcrt L ^ NL IMLLA 1 IVIN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOJI6 THE EXPIRATION City of Santa Ana DATE THEREOF, THE ISSUING INSURER MI-CENDEAOOR-TO MAIL DAYS WRITTEN 20 Civic Center Plaza NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFr.-M7-FA7LORET3TJOSII JRALL PO Box 1988 -IMPOSF'W-OHLTGATIOFORT_"R3T DF-AWY D-UPOWTHETNSORE14TrSAC,ENTS OR -REPRESENTATIVES. Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE 25 12007/081