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F- a OCA 019 - () DA 'ACORq, CERTIFICAT OF LIABILITY INSURA; ;E °oaozzoo5 r PRODUCER Serial # 100168 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERSNO RIGHTS .UPON. THE CERTIFICATE MAGUIRE INSURANCE AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 27101 PUERTA REAL SUITE 200 MISSION VIEJO, CA 92691 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: PHILADELPHIA INDEMNITY INSURANCE CO. NATIONAL COUNCIL ON ALCOHOLISM & DRUG DEPENDENCY ORANGE COUNTY INSURER B: INSURER C: 22471 ASPAN STREET, SUITE 103 LAKE FOREST, CA 92630-1644 INSURER D: 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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MSR LTR e . NSR TYPE OF IN POLICY NUMBER POLICY EFFECTIVE E MMIDDIYY POLICY EXPIRATION DATE M MD/YY -. LIMITS- - GENERAL LABILITY EACH OCCURRENCE $ 1,000,000 PREMISES E.Eoowrence $ 100,000 A X COMMERCIAL GENERAL LIABILITY CLAIMSMADE OCCUR PHPK112365 4/7i2OO5 4/7/2006 MED EXP Arr oae rsao) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP ADD $ 2,000,000 POUCV JECPROT LOC A AUTOMOBILE LIABILITY ANY AUTO PHPK112365 4/7/2005 4/7/2006 COMBINED SINGLE LIMIT (Eaaccieent) $ 1,000,000 BODILY INJURY (Per Person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per aackent) $ HIPPO AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE !Per accitlenq $ GARAGE LIABILITY AUTO ONLYEAACCIDENT $ OTHER THAN EA ACC $ ANY AUTO 8 AUTO ONLY. AGO EXCESSIUMBRELLALIABILITY EACH OCCURRENCE $ 10,000,000 A X OCCUR OCLAIMSMADE PHUE3042424 4/7/2005 4/7/2006 AGGREGATE $ 10,000,000 $ $ DEDUCTIBLE $ RETENTION $ ION AND WC STATU- iH- TORV LIMITS ER LIABILITY EMPLOYERS' LIABILITY EMPLOWORKEEMPLOYERS' ANY PROPRIETORIPARTNERIEXECUTIVE EL EACH ACCIDENT $ EL DISEASE - EA EMPLOYEE $ OFFICERIMEMBER EXCLUDED' I/ yes, tlescribe antler SPECIAL PROVISIONS below EL DISEASE -POLICY LIMIT $ A OTHER EMPLOYEE DISHONESTY $61,000 CRIME PHPK112365 4/7/2005 4/7/2006 PROFESSIONAL $1.000,000 OCC. PROFESSIONAL LIABILITY I AGGREGATE $2.000,000 DESCRIPTION OF OPERATIONSrL ATIONSNEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER IS INCLUDED AS AN ADDITIONAL INSURED WITH RESPECTS TO FUNDING; PLEASE SEE BLANKETED FUNDING FORM ATTACHED, PI-NP-003. CANCELLATION AS NOTED BELOW WITH EXCEPTION: 10-DAY NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN CITY OF SANTA ANA NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL ATTN: FRANK HERNANDEZ IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 20 CIVIC CENTER PLAZA PPRO VED AS TO 1-'"_ ESENTATIVES. AUTHORIZED REPRESENTATIVE ' SANTA ANA, CA 92701 I ' ACORD 25 (2001108) �- — '---- ©ACORD CORPORATION 1988 C'.\FMPROICERTPROS.FPS - Laura t u JhC2i1 }'