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DigitaIlysignedbyToriPierson <br />To r i P i e rs O n Date: 2022.06.21 08:54:32 <br />-07'00' <br />AcoRU® CERTIFICATE OF LIABILITY INSURANCE <br />DAM (MMrDDIYYYY) <br />05/25/2022 <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(*). <br />PRODUCER <br />CONTACT NAME: Certificate Issuance Team <br />Comprehensive Insurance Services <br />PHONE (949)709 6800 FAX (949) 709-1668 <br />28429 Rancho Parkway South <br />ADDRESS: jeremy@thecompmhensWnsurance.00m <br />Suite 120 <br />INSURER(S) AFFORDING COVERAGE <br />NAIC / <br />Lake Forest CA 92630 <br />INSURERA: Nonprofits Insurance Alliance of California <br />10023 <br />INSURED <br />INSURER B : State Compensation Insurance Fund <br />35076 <br />Orange County Fair Housing <br />INSURERC: <br />2021 E. 4th St. Ste. 118 & 122 <br />INSURER D : <br />INSURER E : <br />Santa Ana CA 92705 <br />INSURER F : <br />COVERAGES CERTIFICATE NUMRFR- ULZZ02OUDUUZ nFvlRlnru MEllunco. <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 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 />LTR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE ®OCCUR <br />EACH OCCURRENCE <br />s 1.000,000 <br />PREM S Ea occurrence)S TO RENTED <br />500,000 <br />MED EXP (An v one <br />S 20.000 <br />PERSONAL dADvINJURY <br />S 1.000,000 <br />A <br />Y <br />2022-03733 <br />07/01/2022 <br />07/01/2023 <br />GENIAGGREGATEUMITAPPLIES PER: <br />POLICY ❑ J CT ®LOC <br />GENERAL AGGREGATE <br />= 3,000,000 <br />PRODUCTS -COMPIOPAGG <br />S 3,000,000 <br />t <br />OTHER: <br />I <br />AUTOMOME UABIUTY <br />OM INEO LE N UM1T <br />JE,ANYAUTO <br />t 1,000,000 <br />BODILY INJURY (Per pereon) <br />$ <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />2022-03733 <br />07101/2022 <br />07/01/2023 <br />BODILY INJURY (Per socldeott <br />s <br />PR ITY OAMAGE <br />aMd. <br />$ <br />S <br />UMBRELLA UAB <br />OCCUR <br />EACH OCCURRENCE <br />$ 1,000,000 <br />AGGREGATE <br />$ 1,000,000 <br />A <br />EXCESS UAe <br />CAMS -MADE <br />2022.03733-UMB <br />07/01/2022 <br />07/01/2023 <br />DED I I RETENTION S 10000 <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS LIABILITY <br />ANYPROPRIETOWPARTNERIEXECUTIVE Y!N <br />OFFICEWMEMSER EXCLUDED? <br />[Mandatory In NH) <br />It yea, deaaibe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />9099740 22 <br />05/18/2022 <br />05/18/2023 <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />S 1,000,000 <br />E.L DISEASE - EA EMPLOYEE <br />$ 1,OOD,D00 <br />E.L DISEASE - POLICY LIMIT <br />$ 1,0D0,000 <br />A <br />Improper Sexual Conduct Liability <br />2022-03733 <br />07/01/2022 <br />0710112D23 <br />$1,000,000 Aggregate <br />$1,000,000 Occurrence <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. AddlaonW Remarks SoWu* may be aaaehed If mom space Is required) <br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as Additional Insured per attached endorsement NIAC <br />E61. This insurance is Primary and Non-contributory per 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 Divison <br />20 Civic Center Plaza <br />Santa Ana <br />CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE MILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTWRIZED REPRESENTATIVE <br />01988-2015 ACORD CORPI REMEWED Ps Br <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Mr r <br />`.•'"onISY(Yy�rTei'q�CnXY'At r_�Ci"I G�YAICYIF <br />