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Digitally signed by Tor Pierson on Pierson Date: 2021.10.2008:4828-0700' / ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/14/2021 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 have ADDITIONAL INSURED provisions or 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 (OC) Heffernan Insurance Brokers 18004 Sky Park Circle, Suite 210 CA 92614 CONTACT NAME: PHONE FAX A/C No Ext: 949-771-3400 A/c,No:949-771-3401 E-MIrvine ADDRESS: hibcertrequest@heffins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Nonprofits Insurance Alliance of California 1184 License#: 0564249 INSURED HUMAOPT-04 Human Options, Inc. PO Box 53745 INSURERB: Service American Indemnity Company 39152 INsuRERc: Houston Casualty Company 42374 INSURERD: Irvine CA 92619 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 1078304318 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 INSD SUBR WVD POLICYNUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY Y 202101143 9/23/2021 9/23/2022 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGES(RENTED ccurrence)$ PREMISES Ea occurrence) 500,000 MED EXP (Any one person) $ 20,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY ❑ PRO JECT LOC PRODUCTS - COMP/OP AGG $ 3,000,000 Sexual Misconduct $ 1,000,000 OTHER: A AUTOMOBILE LIABILITY 202101143 9/23/2021 9/23/2022 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LAB X OCCUR 202101143UMB 9/23/2021 9/23/2022 EACH OCCURRENCE $5,000,000 AGGREGATE $ 5,000,000 EXCESS LAB CLAIMS -MADE DED X RETENTION $ n $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N SATISO427000 4/1/2021 4/1/2022 X PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Cyber Liability H21NGP21073300 9/23/2021 9/23/2022 Limit 1,000,000 A Professional Liability 202101143 9/23/2021 9/23/2022 Per Claim Limit 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Re: City of Santa Ana Agreement N-2021-102. The City of Santa Ana, its officers and employees are included as an additional insured (primary and non-contributory) on General Liability policy per the attached endorsements, if required. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 20 Civic Center Plaza 4th floor AUTHORIZED REPRESENTATIVE Risk MmrgmweDiftm Santa Ana CA 92701 ►tEv+e&so & AmovED By @ 1988-2015 ACORD C( - "'S"'wanegemen"'� ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD