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"'CERTIFICATE OF LIABILITY INSURANCE DATE 21DECEC 2 l0 TM. I PRODUCER E.L.M. INSURANCE BROKERS, INC. P.O. BOX 2668 1990 E. GRAND AVE STE 210 CA LIC OD28706 EL SEGUNDO CA 90245-1768 PHONE: 310-322-1301 Agency Lic#:-OD28_7.06 INSURED DONNA DESMOND ASSOCIATES 265 S. BEVERLY GLEN LOS ANGELES CA 90024 /%f11/0n A^ 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 NAIC # INSURER A. Lloyds of London -- ---------- INSURER B: INSURER C: INSURER D: INSURER E: 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 MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN CERTIFICATE MAY BE ISSUED OR IS SUBJECT TO ALL THE TERMS, EXCLUSIONS POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AND CONDITIONS OF SUCH INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE MM/DD DATE MM/DO/ GENERAL LIABILITY NOT INCLUDED '., FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE SANTA ANA, CA 92702 EACH OCCURRENCE $ -- COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ - -_ CLAIMS MADE OCCUR PREMISES (Ea occurencel MED. EXP (Any One Person) $ --- — - --- _ __ _-- PERSONAL&ADV INJURY $ GENERAL AGGREGATE —t$ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG.$ POLICY -- - AUTOMOBILE LIABILITY NOT INCLUDED ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS ------- --T-- ._----- __ -- - SCHEDULED AUTOS APPROVED AS TO FORM BODILY INJURY ! (Per Person) $ HIRED AUTOS -- -- -.- NON -OWNED AUTOS BODILY INJURY $ (Per accident) LdLlid. SZ!(I eedy PROPERTY DAMAGE $ GARAGE LIABILITY MUT OTIIejr ANY AUTO AUTO ONLY - EA ACCIDENT $ —----�------- - - OTHER THAN EA_ACC !$ AUTO ONLY: ------------ AGG ' $ EXCESS / UMBERELLA_LIABILITY NOT INCLUDED EACH OCCURRENCE $ OCCUR CLAIMS MADE --------- - AGGREGATE $ DEDUCTIBLE - - - -- -- - -- --- --`$--------- --- $ RETENTION $ - -----------.-- __ WORKERS COMPENSATION AND NOT INCLUDEDWC EMPLOYERS' LIABILITY STATU- OTHER -- ___7QRy_.LIMITS ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MeMBER EXCLUDED? E.L. EACH ACCIDENT $ It yes, describe under i E.L. DISEASE -EA EMPLOYEEi$ SPECIAL PROVISIONS below ----- --- ---- ----- - E.L. DISEASE -POLICY LIMIT $ OTHER: MISCELLANEOUS 1038013509/010 DEC 4 10 DEC 411 A PROFESSIONAL LIABILITY (CLAIMS $1,000,000 / $1,000,000 LIMITS/// MADE FORM) DESCRIPTION OF OPERATIONS/LOCATION/VEHICLES/EXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER IS NOT ADDED AS AN ADDITIONAL INSURED TO THE REFERENCED POLICY. CERTIFICATE IS FOR PROOF OF PROFESSIONAL LIABILITY COVERAGE. NOTHING IN THIS CERTIFICATE SHALL ALTER, AMEND OR EXTEND COVERAGE PROVIDED BY THE ABOVE MENTIONED POLICY. ALL OTHER TERMS AND CONDITIONS OF THE REFERENCED POLICY REMAIN IN FULL FORCE AND EFFECT. 12/4/97 PRIOR ACTS DATE/// (RFRTIFICATC LJAI non CITY ATTORNEY CITY OF SANTA ANA SHOULD ANY OF, THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 20 CIVIC CENTER PLAZA M-29 ( ) DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT P.O. BOX 1988 FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE SANTA ANA, CA 92702 INSURER, IT'S AGENTS OR REPRESENTATIVES. Attention:---- AUTHORIZED REPRESENTATIVE ACORD 25 (2001;08) Certificate # 4322 Frederick ,1. Fisher 0607799