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ACC7R" CERTIFICATE ®F LIABILITY INSURANCE <br />DATE(MMIDDITY YI <br />0610412019 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement, A Statement on <br />this certificate does not confer rights to the certificate holder In lieu of such endorsement(a). <br />PRODUCER <br />Comprehensive Insurance Services <br />26429 Rancho Parkway South <br />SUlto 120 <br />Lake Forest CA 92630 <br />U."ACTCenlfloate Issuance Team <br />PHONE (949) 709�8800 a (949) 709A668 <br />ADDRESS: Jeremy®lhecomprehensiveinsurance.com <br />INSURER(S) AFFORDING COVERAGE <br />NAICO <br />INSURERA : State Compensation Insurance Fund <br />35076 <br />INSURED <br />Orange County Chlldren's Therapeutic Arts Center <br />2215 N. Broadway <br />Santa Ana CA 92706 <br />INSURERS: <br />INSURERC: <br />INSURER_D: �^ <br />INSURER E <br />INSURER F: <br />rtMTGRAPCR ITERTIEICATE NUMBER- WC REVISION NUMBER. <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />INSIR <br />TYPEOFINSURANCE <br />NSD <br />WV <br />POLICY NUMBER <br />POLICY EFF <br />MMIODNYYY <br />POLICY EP <br />MMIRDIYYYY <br />LIMITSLTR <br />COM MERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />3 <br />CLAIMS -MADE 7 OCCUR <br />DAMAGE TO RENTBO <br />PRFMISFBIR.O.0t ace <br />$ <br />MED EXP (Any one peraon) <br />$ <br />PERSONAL &ADV INJU RY <br />$ <br />GEN LAGGREGATE LI MIT APPLIES PER: <br />GENBRALAGOREGATE <br />$ <br />PRODUCTS-COMPICPAGG <br />$ <br />F <br />POLICY ❑ jEgT u LOC <br />OTHER: <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />Ee sctltlan! <br />$ <br />eODILY INJURY(Per,rsdnl <br />$ <br />ANYAUTO <br />OWNED 77 SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />BODILY INJURY(Pereocidnrq <br />$ <br />PROPERTY DAMAGE <br />Peracddent <br />$ <br />b <br />UMBRELLA LIAD <br />OCCUR <br />OCCURRENCE <br />$ <br />$ <br />EXCESS LIAS <br />CI -AIMS -MADE- <br />DED RETENTION $ <br />PE.�EAGHAOQDENT <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS LIABILITY <br />ANY PROPRIETORIPARTNERIEXECUTIVE Y❑ <br />EXCLUDED9(Mandatmyin NIH) <br />NIA <br />9265171.2019 <br />O6/OS/2019 <br />06/0612020 <br />�RH <br />DENTOFFICERIMEMBER <br />EA EMPLOYEE <br />1,000,000 <br />$ 1,000,000 <br />PO LICV LIMIT <br />1,000,000PESCRIPrION <br />$ <br />byes, deecrlha under <br />OF OPERATION6 below <br />71 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddlfmnH Remark.Schedcro,,nay be attached If more spate is renulmd) <br />30 day notice of cancellation with 10 day notice of cancellatlon for non-payment of premium per policy provision. <br />P/-' <br />fjj I <br />Clly of Santa Ana (The) Finance & Management Services Agency <br />20 Civic Center Plaza <br />PO Box 19BB M•16 <br />Santa Ana CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD <br />