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_ _.. OP ID xJ DATE (MMIOD!'MYY) AC ORD CERTIFICATE OF LIABILITY INSURANCE HUt�.OP1 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 11/D5/08 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE (OC) Heffernan Insurance Brkrs HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1855 Katella Ave, Suite 255 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Orange CA 92867-4459 Phone:714-997-8100 Fax:714-460-9935 INSURERS AFFORDING COVERAGE NAIC# INSURED INSUtERAPhiladelphia IndmnLty Ins. Co nOptions INSURER B Mindy Weiheimer INSURER C5540-A Trabuco Road INSURERo: Irvine CA 92620 INSURER E. CnVFRanwn THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, 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. LTR NSRV NSURANCE POLICY NUMBER POLICY 1EFFE-C-ITyIE DATE (MMODIYY) DATE (MMIDD/Y1') LIMITS A X XGENERAL LIABILITY ADE aOCCUR Misconduct PHPK349810 09/23/08 09/23/09 EACH OCCURRENCE $1,000,000 PREMIsEs(Esoccurence) $100,000 MED EXP (Any one person) $5j,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2, 0 0 0, 0 0 0 GENL AGGREGATE LIMIT APPLIES PER: POLICY JPERC LOC PRODUCTS - COMP/OP AGG $ 1 , 0 00 , D OO Emp Ben. 1,000,000 AUTOMOBILE LIABILITY A ANY AUTO PHPK349810 09/23/08 09/23/09 COMBINED SINGLE LIMIT (Ea accident) $ 1OD000O ALL OWNED AUTOS SCHEDULED AUTOS Beer person)ILY (Per person) $ X HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY / AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC ALTO ONLY. AGG $ $ A EXCESSNMBRELLA LIABILITY X OCCUR CLAIMSMADE PHUB251596 09/23/08 09/23/09 OCCURRENCE $ 4 , 000 , Q Q Q AGGREGATE $ 4 , 000 , 000 $ DEDUCTIBLE X RETENTION $ 10 , 0 0 0 E $ WORKERS COMPENSATION AND WC EMPLOYERS' LIABILITY TORY LIMITS ER E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERWEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below OTHER E.L. DISEASE -POLICY LIMIT $ A Prof. Liability PHPK349810 09/23/08 09/23/09 Occurence $1,000,000 A EmployeeDishonest PHPK349810 09/23/08 09/23/09 Occurence $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Project: Funding to provide counseling services in the City of Santa Ana. City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as additional insured on General Liability policy per attached endorsement PI-NP-003 (9/03). Coverage is Primary & non-contrib utory. *10 Day Notice of Cancellation for non-payment/non-reporting. CERTIFICOTF Hnl nFa CIOFSAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 * DAYS VYRrr EN City of Santa Ana NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Attn : Frank Hernandez IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 20 Civic Center Plaza REPRESENTATIVES Santa Ana, CA 92701 AUTHOR �SEfITATIVE 1988