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' ACQRD CERTIFICATE QF LIABILITY INSURANCE o~ <br />PRODUCER <br />Chapman THIS CERTIFICATE IS ISSUED AS A <br />License #0522024 ONLY AND CONFERS NO RIGHTS U. <br />P. O. Box 5455 A~TER THEHCOVERAG AFFORDED <br />Pasadena CA 91117-0455 <br />Phone; 626-405-8031 Fax; 626--405-0585 INSURERS AFFORDING COVERAGE <br />INSURED <br />DATE(MAVDDIYYYY) <br />!THE CERTIFICATE ~ • <br />'AMEND, EXTEND OR <br />THE POLICIES BELOW <br />NA[C # <br /> INSURER A: Nonprofits' insuranae A1lianae <br />Oxangg''ewoed Children's <br />E`011nd8t~ <br />OnS INSURER B: Everest National <br />. <br />1575 E, 17th Street iNSURERC: Great American insurance Co 16691 <br />Santa Ana CA 92705 INSURER D: Fidelity 6 Deposit Co bJaryland <br />COVERAGES INSURER E: <br />THE POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED TO <br />T <br />ANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACT OR OTH <br />N1AY PERTH{N, THE 1NSUfZ4NCE AFFORDED BY THE PO <br />I HE INSURED INAMEDABOV£ FOR THE POLICY PERIOD INDICATED. NO <br />ER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY B TWITHSTANDING <br /> <br />L <br />E ISSUED OR <br />CIES DESCRIBED HEREIN !S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND COND}TIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REbUCED BY PAID CLAIMS <br />' <br /> <br />D <br />LTR NSR TYPE OF INSURANCE POLICYNUIdBER . <br />PO C EFFECTI E PO X 1RA 0 <br />DATE MMIDD/YY DATE MMIDDIYY <br /> <br />GENERAL LIABILITY LIh1 1T5 <br /> <br />A X X COMMERCIAL GENERALLIABILT[Y 2Q0912778NP0 EACH OCCURRENCE <br />02/01/09 02 O1 10 ~6R~D- <br />/ / S 1000000 <br />_ <br />CLAIMS MADE Q OCCUR PREMISES {Eaaccurence) S IOOOOO <br />X Prof Liability MEDEXp(Anyonepersonj $ 20000 <br /> <br />X Abuse Liab].11ty PERSONAL6ADVINJURY S 1000000 <br /> <br />GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3000000 <br />POLICY JECT X LOC PRODUCTS•COMPIOPAGG S 3000000 <br />AUTOMOBILE LIABILITY Em ~' Ben Included <br />+~+ ANYAl1T0 200912778NPC 02/01/09 02/01/10 ~°MBwEOSINGLEUMIi <br />Ea aceidentj $ 1000000 <br />ALL OWNED AUTOS <br />SCHEDULEDAU70S BODILY INJURY <br /> <br /> <br />X HIRED AUTOS <br />(Per person} $ <br />X NON-OWNED AUTOS p~ 1`r~' BODILY INJURY <br />~ <br /> ~~ trio ~y <br />(Peraccident) <br />!• S <br />V <br />~ <br />pgp PROPERTY DAMAGE <br />c, (Peraccideni) <br />S <br />GARAGE LIABILITY ' <br />~ ~ <br />AUTO ONLY <br />'(ORG <br />FA AC <br />ANYAUTO - <br />~, S <br />CIDENT <br />~0y <br />~~O $ <br /> OTHER THAN EA ACC <br />t pity A <br />~; <br />a S <br /> <br />EXCESSNMBRELLA LIABILITY { <br />p <br />AUTOONLY: AGG $ <br />OCCUR ~ CLAIMS MADE EACH OCCURRENCE S <br /> AGGREGATE S <br />DEDUCTIBLE S <br />RETENTION S $ <br />WORKERS COMPENSATION ANR S <br />B EMPLOYERS'LIABfLITY <br />ANY pROPRIETORlPARTNER/EXECUiIVE 6600001013091 <br />OFFICER/MEM TORY LIMITS X ER <br />03/01/09 03/O1/1O E <br />' <br />BEREXCLUDED? .LEACHACCiDENT $ 1000000 <br />If yes, describe under <br />SPECIAL PROVISIONS below E.L.OISEASE- EA EMPLOYE S 1000000 <br />OTHER E,L.DISEASE-POUCYLIMR S 1000000 <br />C Property Coverage PAC757534603 02/01/09 02/01/10 Blkt Cont <br />D Crime Covera a CCP006190604 02/01/09 02/01/10 Em 1 Dish $666,000 <br />D ESCRIPiION OF OPERATIONS 1 LOCATIONS /VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT !SPECIAL PROVISIONS ~ 5O O , O O O <br />The City of Santa Ana, it's officers, employees, agents, volunteers and <br />representatives are named as an Additional Insured as respects liability <br />arising from the operations of the Named Insured per the attached CG 2026 <br />endorsement. Workers compensation coverage excluded, evidence only. 10 days <br />notice of cancellation for non-payment of premium, }p{ <br />:ERTIFICATE HOLDER CANCELLATION <br />CITYSAN SHOULD ANY OF THEA80VE DESCRIBED POL[C1ES I;E CANCELLED BEFORE THE EXPIRATII <br />DATE THEREOF, THE ISSUING INSURER WI~ <br />AIL 3O DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAh1ED TO THE LEFT, <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 AL3TFY/1R17R ~oor~..~,.. _..._ <br />O ACORD CORPO <br />