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Digitally signed by Francine F.
<br />Francine R. Villareal Villareal
<br />Date'. 2021 L 1261631 0800'
<br />ACOR" CERTIFICATE OF LIABILITY INSURANCE
<br />DAM1/12/2DIY
<br />onz/zoz1
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<br />THIS CERTIFICATE IS ISSUED ASA 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 A 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 policy(ies) 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(s).
<br />PRODUCER
<br />CONTACT Certificate Issuance Team
<br />NAME:
<br />Comprehensive Insurance Services
<br />Ac°NNo (949) 709-6600 (949) 709-1668
<br />Eat: (AacNo:
<br />26429 Rancho Parkway South
<br />E-MAIL jeremy@thecomprehensiveinsurance.com
<br />ADDRESS:
<br />INSURERS) AFFORDING COVERAGE
<br />NAIC#
<br />Suite 120
<br />INSURERA: Nonprofits Insurance Alliance of California
<br />10023
<br />Lake Forest CA 92630
<br />INSURED
<br />INSURER B: Starl Insurance Company
<br />40045
<br />Delhi Center
<br />INSURER C:
<br />505 E. Central Ave.
<br />INSURER D:
<br />INSURER E
<br />Santa Ana CA 92707
<br />INSURERF:
<br />COVERAGES CERTIFICATE NUMBER: CL20101904920 REVISION NUMBER:
<br />THIS ISTO CERTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMEDABOVE FORTHE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF IN SURANCE
<br />ADDLSUBK
<br />INSD
<br />Will
<br />POLICYNUMBER
<br />POLICY EFF
<br />MWDDIYYYY
<br />POLICY UP
<br />IWDDIYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERALLWBILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAMS -MADE Fx_] OCCUR
<br />PREMISES Ea occurrence
<br />$ 500,000
<br />MED EXP (Any one person)
<br />$ 20,000
<br />PERSONAL&ADV INJURY
<br />$ 1,000,000
<br />A
<br />Y
<br />2020-01376
<br />11/01/2020
<br />11/01/2021
<br />GEN'LAGGREGATE LIMIT APPLIES PER
<br />GENERALAGGREGATE
<br />$ 3,000,000
<br />POLICY PELT FX-1 LOC
<br />PRODUCTS-COMP/OPAGG
<br />$ 3,000,000
<br />$0 Deductible
<br />$
<br />OTHER'.
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINEDSINGLE LI MIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY I sal (Per person)
<br />$
<br />ANYALTO
<br />A
<br />OWNED SCHEDULED
<br />ALTOS ONLY ALTOS
<br />2020-01376
<br />11/01/2020
<br />11/01/2021
<br />BODILY Isal (Per accident)
<br />$
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED NONFOWNED
<br />ALTOS ONLY X ALTOS ONLY
<br />$0 Deductible
<br />$
<br />UMBRELLALIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LIAB
<br />CLAIM&MADE
<br />DED I I RETENTION $
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />R/ExEcuTroE ❑
<br />ANY CERYMEETOR EXCLUDED?
<br />O /M EM BER EXCLUDED9
<br />(Mandellfyes,din NH)
<br />NIA
<br />BNUWC0152622
<br />11/01/2020
<br />11/01/202,
<br />X STATUTE ERH
<br />$O Deductible
<br />E.L. EACH ACCI DENT
<br />$ 1,000,000
<br />E.L. DISEASE-EAEMPLOYEE
<br />1,000,000
<br />$
<br />Dyes, IP71 be under
<br />DESCRIPTION OF OPERATIONS below
<br />OFF
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />$
<br />A
<br />Social Service Professional Liability
<br />Improper Sexual Conduct Liability
<br />2020-01376
<br />11/01/2020
<br />11/01/2021
<br />$3,000,000/1,000,000
<br />$1,000,000/1,000,000
<br />Aggregate/Occurr.
<br />Aggregate/Occurr.
<br />I
<br />$0 Deductible
<br />DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES ACORD IDI,Additional Remarks Schedule, may be adached if more space is required)
<br />City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this policy pursuant to written contract, agreement, or
<br />memorandum of understanding per attached endorsement CG2026. Such insurance as is afforded by this policy shall be primary, and any insurance carried
<br />by City shall be excess and noncontributory per attached endorsement NIAC E61. 30 day notice of cancellation with 10 day notice of cancellation for
<br />non-payment of premium per policy provision.
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza
<br />Santa Ana
<br />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 />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />Rime Management Dial aian
<br />rREVIEWED &{APPRO�V�ED By.,
<br />o_4.Ilil _II.IPJ-z' rAs6HlM�e ram. M.,dati
<br />® Risk Management Analyst
<br />
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