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ACORQ4 CERTIFICATE OF LIABILITY INSURANCE 1 0DATE (MWDONYYY) 4/19/2010 PRODUCER 310.393.9477 FAX 310.393.7186 White Sutton & Company Insurance Services P 0 Box 70 Santa Monica, CA 90406 -0070 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 # INSURED Women's Transitional Living Center PO Box 6103 Orange, CA 92863 INSURERA: Philadelphia Ins Co POLI Y EFFECTIVE INSURER B: LIMITS INSURER C: PJSURER D: PHPK547344 INSURER E: 04/04/2011 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 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. IN$R JJJL D' TYPE OF INSURANCE POLICY NUMBER POLI Y EFFECTIVE P r ATI LIMITS GENERALUABILrrY PHPK547344 04/04/2010 04/04/2011 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 CLAIMS MADE I OCCUR MED EXP (Any one person) $ 15,000 A PERSONAL d ADV INJURY $ 1.0001000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIAR APPLIES PER: PRODUCTS • COMNOP AGG $ 11000,000 POLK:Y jE a LOG AUTOMOBILE LIABILITY ANYAUTO PHPK547344 04/04/2010 04/04/2011 COMBINED SINGLE LIMIT (Eaauldenl) $ 1,000,000 BODILY INJURY (Per person) $ A ALL OWNED AUTOS X SCHEDULED AUTOS X HIREDAUTOS X NON -OWNED AUTOS App VED AS LISA �+ Si Cilty poll% -- ' CK v �C../ 0rile7 BODILY INJURY (Peraccldont) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY } 1( AUTO ONLY • EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGO $ ANY AUTO 7 $ EXCESSfUMBRELLA LIABILITY PHUB302335 04/04/2010 04/04/2011 EACH OCCURRENCE $ 5,000,000 X OCCUR FI CLAIIAS MADE AGGREGATE $ 5,000,000 $ A $ DEDUCTIBLE X RETENTION $ 10,00 $ WORKERS COMPENSATION AND VC STATU I1, O R DRY Tj EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEWEXECUTIVE OFFICEWMEMBER EXCLUDED? E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ Y Yes, describe under SPECIAL PROVISIONS below E.L. DISEASE •POLICY LIMIT $ OTHER itylof SantaAAnagILitsDO $Mcers,Eagents, employees, and$voAlunteers$are additional insureds as per form G 20 26 07 04 and Primary Insurance as per form CG00 01 1207, both attached to the general liability policy and accompanying this certificate. *Except for 10 days written notice of cancellation for non - payment of premium. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Santa Ana - CDBG M -25 EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL ESG 30" DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn : Frank Hernandez BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY P.O. Box 1988 M -25 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE Ellie Liu CISR ELI ACORD 25 (2001!08) FAX: 714.647.6549 OACORD CORPORATION 1988