GRANDMA'S HOUSE OF HOPE (6) - 2015

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ACOR& CERTIFICATE OF LIABILITY INSURANCE EDATE(MMIDDIYYYY) TYPE OF INSURANCE 6/22/2015 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 pollcy(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 CONTACT NAME: Comprehensive Insurance Services HONE(949)709--6600 FAX AIC No:1949j709-1666 26429 Rancho Parkway South ADDRIESS:info@ thecomprehensive insurance. com INSURERS AFFORDING COVERAGE NAIC 9 Suite 120 INSURERA:State Compensation Insurance Fund 35076 Lake Forest CA 92630 INSURE=D INSURER 8: Grandma's House of Hope INSURERC: 174 West Lincoln Avenue INSURER D; #541 COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY {Por person) $ BODILY INJURY Per accident $ ( ) INSURER E: Anaheim CA 92805 INSURER F: UMBRELLA LIAB EXCESS LIAB COVERAGES CERTIFICATE NUMBER -WC RFVISION N11MRFIR- 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 SUBR POLICY NUMBER POLICY EFF IMMIDDfYYYY POLICY EXP MMlDDNYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F-1 OCCURDAMA EACH OCCURRENCE $ RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: POLICY ❑ PEO LOC OTHER: GENERAL AGGREGATE $ PRODUCTS - COMPIOP AGG $ _ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY {Por person) $ BODILY INJURY Per accident $ ( ) PROPERTY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNER/EXECUTIVE CFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A A 9028555-15 6/1/2015 6/1/2016 STATUTE ETH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ i, a00 , 000 171, DISEASE -POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) VCr[ I Irn A I C rIVLUCI[ L;ANt;tLLA I IUN `f City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 ACORD 25 (2014101) INCf19.ri ron4nn4� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Jeremy Eynon/JEREMY'' V 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD