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ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID ZH
<br />HUMAOPI
<br />DATE(MMIDDNYYY)
<br />1 091 3/09
<br />PRODUCER
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />INS R' DDT{" -- "--" '" —1 POL>:C EFltECT' B 6YICY1�XPlR -AY(0 - - -- LIMITS
<br />LTR PNSRD TYPE OF INSURANCE POLICY NUMBER (DATG MM/0D DATE MM/DDIYY
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />(OC) Heffernan Insurance Brkrs
<br />1855 Katella Ave, Suite 255
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />Attns Frank Hernandez
<br />IMPOSE NOOBLIOATIONOR LIABILITY OF ANY MIND UPON THE INSURER, RS AGENTS OR
<br />Orange CA 92867 -4459
<br />Phones 719- 997 -8100 Fax:714 -960 -9935
<br />INSURERS AFFORDING COVERAGE
<br />NAIC#
<br />..— .._.........---.. -... -0-.....00.... ....0_...- __...........,.-•---- 00...0..0. - - --
<br />INSURED
<br />------- .- ..._'__ __. _- 0000._
<br />INSURER& Phllodolphie Xnd.Mity In- co
<br />...----"-- ---- '-'--'-'- '- ---- --'-_
<br />-.....-__..-...._,_,. --
<br />Hunan 0pionar
<br />I ffiT}dy Nte nheimer
<br />554Q -A Trabuco Road
<br />Irvine CA 92620
<br />INSURER B:
<br />_- --- - -- '--.. - - ' --
<br />INSURERC
<br />INSURERD - - --- - 00.,0..0.--- --- '-- -- - --.._.
<br />--- _............. ,: — -- ..-
<br />DWtABETO'RENTFA"
<br />PREMISEB(Estoccut�S
<br />_....- . —' —. --
<br />-- ..... - - - --
<br />INSURER E:
<br />CEAIAi36NDE LOCCUR
<br />COVERAGES
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED HAMEO ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES. AOOREOATE LIMITS SHOWN MAY HAVE BEEN REDUCED DY PAID CWMS.
<br />INS R' DDT{" -- "--" '" —1 POL>:C EFltECT' B 6YICY1�XPlR -AY(0 - - -- LIMITS
<br />LTR PNSRD TYPE OF INSURANCE POLICY NUMBER (DATG MM/0D DATE MM/DDIYY
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THS LEFT, BUT FAILURE TO GO SO SHALL
<br />City Of Santa Ana
<br />GENERAL LIABILITY
<br />Attns Frank Hernandez
<br />IMPOSE NOOBLIOATIONOR LIABILITY OF ANY MIND UPON THE INSURER, RS AGENTS OR
<br />20 Civic Center Plaza
<br />EACH OCCURRENCE
<br />S1,000,000
<br />A
<br />X
<br />CO MMERCIAL GENERAL LIABILITY
<br />PHPK473465
<br />09/23/09
<br />09/23/10
<br />DWtABETO'RENTFA"
<br />PREMISEB(Estoccut�S
<br />- 100, 0
<br />100, 000
<br />CEAIAi36NDE LOCCUR
<br />MEOEXP(Myglepetson)
<br />55,000
<br />PERSONAL6ADVINJURY
<br />$1,000,000
<br />X
<br />JX
<br />Sexual Misconduct
<br />GENERAI.AGGREGATE -
<br />s2,000,000
<br />PRODUCTS - COM_P!_OPAGO
<br />$1,000_,_000
<br />GEML AGGREGATE LIMIT APPU ES PER:
<br />POLICY JECDT Loa
<br />File Ben. —
<br />1,000,000
<br />AUTOMOOILE LIABILITY
<br />COMBINED SINGLE LIMIT
<br />S1000000
<br />A
<br />ANYAUTO
<br />PHPK473465
<br />09/23
<br />09/23/10
<br />(Er rcc.dent)
<br />BODILY INJURY
<br />$
<br />ALL OWNED AUTOS
<br />r V I
<br />SCHEDULED AUTOS
<br />P-
<br />(Par Petlan)
<br />BODILYINJURY
<br />(Perdeddent)
<br />X IgREOAUTOS�1
<br />S
<br />X NON - OWNEO AUTOS
<br />_.._.
<br />.•
<br />�ACV,
<br />_..— -- --- -- - -_....
<br />vs
<br />`PROPERTYDAMAGE
<br />5
<br />.t A��OCney
<br />OARAOELUIBILITY
<br />ASC,�IS
<br />AUTO ONLY- EAAOCIDENT
<br />$
<br />ANYAUT0
<br />1
<br />, - -__
<br />S
<br />_
<br />OTHERTHAN , ACC
<br />- -_ -_
<br />$
<br />'"�
<br />AUTO ONLY: AGO
<br />EACHOCCURRENCE
<br />4,000, 000
<br />A
<br />_EXCESSJUMBRELLALIABILITY
<br />OCCUR n CWMSMADE
<br />FRUB285210
<br />09/23/09
<br />09/23/10
<br />_ _
<br />AGGREGATE N - -- _
<br />s4;000,000
<br />dDEDUCTIBLE
<br />RETENTION $10,000
<br />- . - -_._
<br />5
<br />WORKERS COMPENSATION AND
<br />11A 1 ER
<br />EMPLOYERS'LIABILFTY
<br />" ""--- - - - -' --
<br />'-
<br />E.L.EACHACCIOENT
<br />ANYPROPRIETOR'PARTNER/EXECUTNE
<br />OFFICERIMEIAIER EXCLUDED?
<br />5
<br />E.L. DISEASE -EA EMPLOYEE
<br />If yes. descdbe under
<br />SPECIAL PROVISIONS WIN,
<br />$
<br />E.L. DISEASE • POLICY LIMIT
<br />OTHER
<br />A
<br />Prof. Liability
<br />PHPK473465
<br />09/23/09
<br />09/23/10
<br />Occurence $1,000,000
<br />A
<br />Em to eeDishonest
<br />PHPK473465
<br />09/23/09
<br />09/23/10
<br />Occurence $1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS J VEHICLES t EXCLUSIONS ADDED BY END CASEMENT I SPECIAL PROVISIONS
<br />Projects Funding to provide counseling services in the City of Santa Ana.
<br />City of Santa Ana, its officers, employees, agents, volunteers and
<br />representatives are named as additional insured on General Liability policy
<br />per attached endorsement PI -NP -003 (9/03). Coverage is Primary a non- eontrib
<br />utory. *10 Day Notice of Cancellation for non - payment /non - reporting.
<br />CERTIFICATE HOLDER CANCELLATION
<br />CIOFSAN
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE THE EXPIRATION
<br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL 30* DAYSWRITTEN
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THS LEFT, BUT FAILURE TO GO SO SHALL
<br />City Of Santa Ana
<br />Attns Frank Hernandez
<br />IMPOSE NOOBLIOATIONOR LIABILITY OF ANY MIND UPON THE INSURER, RS AGENTS OR
<br />20 Civic Center Plaza
<br />REPAESENT TNEB.
<br />AUTHOR NTATNE
<br />Santa Ana, CA 92701
<br />ACORD 25 (2001108) ©ACORD CORPORATION 1988
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