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ACCORD CERTIFICATE OF <br />LIABILITY <br />INSURANCEDATE(MMAOlYYYY) <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />05/17/2013 <br />PRODUCER (949) 218-0840 <br />Global Program Managers & Ins. Srvcs., <br />'3 4 <br />Post Office Box 7119 <br />Capistrano Beach CA 92624-7119 <br />Inc. <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE NAIC# <br />INSURED <br />KidWorks Community Development Corporation <br />1902 West Chestnut Avenue <br />Santa Ana CA 92703- <br />INSURERA: PHILADDELPHIA INDEMNITY 18058 <br />INSURERS: EVEREST NATIONAL 10120 <br />I NSURERC: <br />/ / <br />INSURER D: <br />I INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR ADD-LI <br />LTR NSRD <br />TYPE OF INSURANCE <br />POLOYNUMBER <br />DATE Dm <br />ATE()PD <br />DYN <br />ATE MMIpY)j <br />LIMITS <br />A <br />GENERAL LIABILITY <br />INVESTMENT BOARD <br />/ / <br />/ / <br />EACH OCCURRENCE <br />$ 1,000,000 <br />Santa Ana CA <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE OCCUR <br />/ / <br />/ / <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />$ j00, 000 <br />MED EXP Any one per son) <br />$ 5,000 <br />PERSONAL B ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 3,000,000 <br />PHPK 957 375 <br />01/07/2013 <br />01/07/2014 <br />GFN'L AGGREGATE LIMIT APPLIES PER <br />PRODUCTS -COMMOPAGG <br />$ 3,000,000 <br />X POLICY71 JECT 71 LOO <br />It <br />t <br />I J <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />/ / <br />/ % <br />COMBINED SINGLE LIMIT <br />(Ea accident} <br />$ 1,000,000 <br />A11OWNEDAUTOS <br />SCHEDULED AUTOS <br />/ / <br />/ / <br />BODILY INJURY <br />(Per person) <br />$ <br />X <br />X <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />POPE 957 375 <br />01/07/2013 <br />01/07/2014 <br />BODILY INJURY <br />(Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHERTHAN EAACC <br />$ <br />ANYAUTO <br />/ / <br />/ / <br />$ <br />AUTO ONLY: AGC <br />EXCESStUMBRELLA LIABILITY <br />/ / <br />/ % <br />EACH OCCURRENCE <br />S <br />AGGREGATE <br />> <br />OCCUR F7 CLAIMS MADE <br />UCDUCTIBLE <br />$ <br />RETENTION $ <br />B WORKERS COMPENSATION AND <br />EMPLOYERS'LIABILITY <br />ANY PROPRIETOWPARTNERIEXECUTIVE <br />$900001267-131 <br />02/01/2013 <br />02/01/2014 <br />XWCSTATU- D - <br />TORV LIMITS ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />OFPICERIMF-:MBER EXCLUDED? <br />If yes, descdhu under <br />SPECIAL PROVISIONS below <br />/ / <br />/ / <br />E.L. DISEASE -POLICY LIMIT <br />$ 1,000,000 <br />OTHER <br />A PROFESSIONAL LIAS <br />PUPA 957 375 <br />01/07/2013 <br />01/07/2014 <br />EACH INCIDENT $1,000,000 <br />POLICY AGGREGATE $1,000,000 <br />DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES;EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br />RE: CITY OF SANTA ANA YOUTH COUNCIL WORKFORCE CONTRACT <br />CITY OF SANTA ANA NAMED AS ADDITIONAL INSURED PER ATTACHED SPECIAL ENDORSEMENT <br />IN THE EVENT OF NON-PAYMENT OF PREMIUM, ONLY TEN (10) DAYS NOTICE WILL BE GIVEN, <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2001108) ItU A0 D,' iATION 1988 <br />1NS425 (ouU}.ot E•ticTRONIC LASER FORMS, INC, (som32"C54; � - . Pam i oE2 <br />EISA F`, TOROK <br />Assizt�111i City Attorney ��s <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />030 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO TI IE LEFT, BUT <br />BANTA ANA YOUTH COUNCIL <br />WORKFORCE <br />FAILURE TO DO $0 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br />INVESTMENT BOARD <br />INSURER, ITS AGENTS OR REPRESENTATIVES, <br />AUTHORIZED REPRESENTATIVE <br />1000 E. Santa Ana Blvd.., #200 <br />Santa Ana CA <br />92701- <br />ACORD 25 (2001108) ItU A0 D,' iATION 1988 <br />1NS425 (ouU}.ot E•ticTRONIC LASER FORMS, INC, (som32"C54; � - . Pam i oE2 <br />EISA F`, TOROK <br />Assizt�111i City Attorney ��s <br />