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UN IU: VP 14,11c"R° CERTIFICATE OF LIABILITY INSURANCE (MM/DDNYYY) rATE 1/12 08/3 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 619-937-0164 CONTACT NAME: Rancho Mesa Insurance Services 619 937 0168 A - - 250 Riverview Parkway #401 No Ext : A/C No : Santee, CA 92071 E-MAIL ADDRESS: Sam Brown PRODUCER LEGAL-3 CUSTOMER ID #: INSURERS AFFORDING COVERAGE NAIC # INSURED Legal Aid Society of Orange INSURERA:C press Insurance Company 10855 County INSURER B : 2101 North Tustin Avenue INSURER C Santa Ana, CA 92705 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL UB POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY III DAMA E T RENTED PREMISES Ea occurrence $ CLAIMS MADE O C - UR C MED EXP (Any one person) $ PERSONAL & ADV INJURY $ i GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ POLICY P JECT RO LOC $ AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO A BODILY INJURY (Per person) $ LL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR j EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE ? $ RETENTION $ ? $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS' LIABILITY T CRY LIMITS I ER A ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? r N / A 3300062363-121 09/01/12 09/01/13 E.L. EACH ACCIDENT $ 1,000,00 (Mandatory in NH) f 1 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 I yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: PROOF OF INSURANCE CITSANT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CDBG M-25 ACCORDANCE WITH THE POLICY PROVISIONS. COMMUNITY DEVELOPMENT AGENCY P.O. BOX 1988 AUTHORIZED REPRESENTATIVE SANTA ANA, CA 92702 ,).f C 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD