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Frane(neR. `, Digitally signed byFrancine R.
<br />2 Villareal
<br />Villareal -Date. 2021.08.1010.47:45
<br />-07'00'
<br />.4CORV CERTIFICATE OF LIABILITY INSURANCE
<br />DATE iMM10DfrYYY,
<br />7/28/2021
<br />THIS CERTIFICATE IS ISSU ED 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 ADOITIONAL INSURED, the policy(les( must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may roquhe an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder In lieu of such endomement(s).
<br />PRODUCER
<br />Conroy Ina Brokers & Risk Managars
<br />2522 N. Santiago Blvd.
<br />LiC#0543173
<br />Orange CA 92067
<br />NAME;
<br />Christine Campbell
<br />PANONE
<br />S. (877)450-1.872 IFArc No), (71o8.e-016s
<br />nano
<br />ss,chxistinaciconxeyins. ooro
<br />INSURERIS) AFFORDING COVERAGE
<br />NAIC 0
<br />W
<br />INSURERA:Noar rofits Ins Alliance Of Ca
<br />11845
<br />INSURED
<br />South County Outreach
<br />7 Whatney, Ste B
<br />Irvine CA .02610
<br />INSURERS: E 1G ax8 Preferred Ins Co
<br />10346
<br />INSURERC:
<br />INSURERD:
<br />INSURERE:
<br />INSURERF:
<br />COVERAGES CERTIFICATE NUMBER:2D-21 NIAC-E6 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OFANY 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 SHOVM MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INBR
<br />TYPE OF INSURANCE
<br />DL
<br />SUBRIPOLICY
<br />POLICY NUMBER
<br />EFF
<br />MMlDOiYYYY
<br />POLICY EXP
<br />MMID Y
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LABILITY
<br />CLAIMS -MADE OCCVR
<br />EACN tlCOURRENCE
<br />$ 1,OD0,000
<br />OA AO T R NTED
<br />PREMISES Ea..manee
<br />$ 500,000
<br />MED EXP(Any was emwe)
<br />a 20,OD0
<br />X
<br />Y
<br />2o2U-22UL5
<br />11/1/2D20
<br />11/1/2021
<br />PERSONAL& ADV INJURY
<br />a 1, ODD, 000
<br />GENTAGOREGATE LIMITAPPLIES PER:
<br />n
<br />X POLICY LJ PEOT LOC
<br />GENERALAGGREOATE
<br />$ 2,000,000
<br />PHODUCT8-COMPrDPAOG
<br />$ 2,000,000
<br />Employees n dts
<br />$ 1,000,000
<br />OTHER•
<br />AUTOMOBILE LIABILITY
<br />LIMIT
<br />COaBm
<br />9 11000,000
<br />BODILY INJURY (Per renown)
<br />a
<br />ANYAUTO
<br />ALL OS OWNED
<br />AUTOSULED
<br />2020-22015
<br />11/1/2020
<br />11/1/2021
<br />BODILY INJURY(P. $odder)
<br />I}
<br />X HIREOAME X AUOTOsWNED
<br />PR�OPEORTY OHMAGE
<br />a
<br />Unlnsumd m*,Ist mmbined ample
<br />Is 1,000,000
<br />UMBRELLALIAS
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />DED RETENTION $
<br />a
<br />8
<br />WORMERSCOMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE I
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatary In NN)
<br />WA
<br />MIG273013802
<br />11/1/2020
<br />11/1/2021
<br />IfPER-OTW
<br />STATUT
<br />E.L. EACH ACCIDENT
<br />$ 1 000000
<br />EL. DISEASE -EA EMPLOYEE
<br />$ 11000,000
<br />It domire untloc
<br />E.L. DISEASE POLICY LIMIT
<br />is 1,000,000
<br />gs,
<br />DESCRIPTION OFOPERATIONS Wow
<br />A
<br />PROFESSIONAL LIABILITY
<br />2020-22015
<br />11/1/2020
<br />11/1/2021
<br />EACH PROF INCIDENT LIMIT $1,000,000
<br />AGGREGATS LIMIT 42,000,000
<br />DESCRIPTION OFOPBRATIONS I LOCATION$ I VEHICLES (ACORO 1D1, Addiilowal Remark. S.Worla, may M Rlraahod IT more epoao Io roquims
<br />CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED/PRIMARY AND NONCONTRIBUTORY PER ENDORSEMENT NIAC-E61 C219.
<br />WAIVRR Or SUBROGATION APPLIES PER ENDORSEMENT NIAC-E26 1117 WHEN AGREED TO BY WRITTEN CONTRACT OR ACREEbIENT.
<br />POLICY CONTAINS 30 DAY CANCELLATION CLAUSE. 10 DAYS NOTICE IN THE EVENT OF CANCELLATION FOR NON-PAYMENT,
<br />*City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this
<br />polioy pursuant to Written Contract, agreement, or alomorandum of understanding. Such insurance as is
<br />afforded by this policy shall be primary, and any insurance carried by City shall be excess and
<br />noncontributory.
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center plaza
<br />Santa Ana, CA 92702
<br />ACORD 25(2014101)
<br />INS025 (201401)
<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 REPREBENTATIVE
<br />CampbelUCC
<br />® 1988.2014 ACORD C I `¢�F� REVIEW�ED&APPROVED.iBY:
<br />The ACORD name and logo are registered marks of ACORD 1�'4.84aF.
<br />' Rak Mmnagemect Analyst
<br />
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