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Digitally signed by Francine R.
<br />Francine R. Villareal Villareal
<br />A� " CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />05/25/2021
<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 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 Lena Marrujo
<br />NAME:
<br />FALCON WEST INSURANCE BROKERS, INC.
<br />a/cNr.Ext: (619)297-9181 ac,No: (619)297-3366
<br />License # 0616640
<br />E-MAIL lenam@falconwest.com
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />2525 Camino Del Rio S Ste 100
<br />San Diego CA 92108
<br />INSURERA: Federal Insurance Company
<br />20281
<br />INSURED
<br />INSURERB: Citizens Insurance Company ofAmerica
<br />31534
<br />Stanbridge University, Inc.
<br />INSURER C : Allmerica Financial Benefit Insurance Company
<br />41840
<br />2041 Business Center Drive
<br />INSURER D : The Hanover Insurance Company
<br />22292
<br />INSURER E : Indian Harbor Insurance Company
<br />36940
<br />Irvine CA 92612
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: 21-22 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 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 INSURANCE
<br />INSD
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MWDD/YYYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE OCCUR
<br />DAMAGE TO
<br />PREM SES Ea 0NcurrDence
<br />$ 100,000
<br />MED EXP (Any one person)
<br />$ 15,000
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />B
<br />Y
<br />ZB3-D302621-04
<br />07/02/2021
<br />07/01/2022
<br />LAGGREGATE LIMITAPPLIES PERGENERAL
<br />AGGREGATE
<br />$ 3,000,000
<br />POLICY ElPRO ❑X LOC
<br />JECT:
<br />MOTHER
<br />PRODUCTS-COMP/OPAGG
<br />$ Included
<br />$
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANYAUTO
<br />C
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />AW3-D302637-04
<br />07/02/2021
<br />07/01/2022
<br />BODILY INJURY (Pe r accide nt)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />D
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />UH3-D302626-04
<br />07/02/2021
<br />07/01/2022
<br />DED I X1 RETENTION $ 0
<br />XS over GL,AL,EL
<br />$
<br />AOFFICER/MEMBER
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABI LI TY YIN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />EXCLUDED?
<br />(Mandatory in NH)
<br />NIA
<br />71835392
<br />04/06/2021
<br />04/06/2022
<br />X STATUTE EORH
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />$
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />$
<br />ELL Each Claim Limit
<br />$2,000,000
<br />E
<br />Educators Legal Liability
<br />Employment Practices Liability
<br />ELL0950598-03/TBD
<br />07/01/2021
<br />07/01/2022
<br />EPL Each Claim Limit
<br />$1,000,000
<br />Policy Aggregate Limit
<br />$4,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />City of Santa Ana its officers, employees, agents, volunteers, and representatives is included as additional insureds. Certificate of Insurance shall provide
<br />thirty (30) day prior written notice of cancellation
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />Risk Management Div. 4th Floor
<br />20 Civic Center Plaza
<br />Santa Ana
<br />ACORD 25 (2016/03)
<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 />AUTHORIZED REPRESENTATIVE
<br />@ 1988-2015
<br />The ACORD name and logo are registered marks of ACORD
<br />�oRaN Risk ManagementDivisian
<br />REVIEWED & APPROVED BY.-
<br />o z
<br />Risk Management Analyst
<br />
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