SHELTER PROVIDERS OF ORANGE COUNTY, INC., DBA HOMEAID ORANGE COUNTY (2)

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Francine R. moini,s,ed eyFrancine e ae i Villareal rate vsaasaffik' /_aaN BUILIND-03 '4�� CERTIFICATE OF LIABILITY INSURANCE EY BURG DA1112312021TE Y) 11123/2021 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 endorsements . PRODUCER License # OC88587 CDS Insurance Services 2001 E. Financial Way, Suite 200 Glendora, CA 91741 cQ eCT Certificate Department PHONE FA% AIc, No. Eat): (626) 610-9500 AIc, No :(626) 610-9299 certificates@cdsinsurance.com INSURERS AFFORDING COVERAGE NAIC0 INSURER A : Travelers Ind Co of CT 25682 INSURED Shelter Providers of Orange County DBA: HomeAid Orange County 17821 17th Street, Suite 120 Tustin, CA 92780 INSURER B : Travelers Prop Cas Co of America 25674 INSURER c: State Compensation Ins. Fund 35076 INSURER D : INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: RFVIRION NIIMRFR- 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 TYPE OFINSU RANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR Com LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [X] OCCUR P-660-506D7877-TCT-21 121112021 121112022 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED 300,000 MED EXP (Any one arson 5,000 PERSONAL& ADV INJURY Excluded GEN'L AGGREGATE LIMIT APPLIES PER T LOC 2,000,000POLICY COMP/OP AGG 21000,000OTHER:A AUTOMOBILE LIABILITY AUTO SCHEDULED AURRTEEOS ONLY AUU�T�0OIpSS AUrOS ONLYAMAGE BA-1 L302926-21.43-G 121112021 12/112022 WGENERALAGGREGATE$GREGATE INGLE LIMIT 1,000,000ANY Y Per arsonOWNED Y Per accidentXAlfrO60NLV B UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE EX-8J573284.21.43 121112021 12/112022 EACH OCCURRENCE 5,000,000 X AGGREGATE 51000,000 DIED X RETENTION$ D C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEMEXECUTIVE YIN FMa'CER/Mdatoryin BER NH)EXCLUDED? Xyes, describe under DESCRIPTION OF OPERATIONS below N/A 9147184-21 111112621 111112022 j( IPER OTH- E.L. EACH ACCIDENT 1,ggg,000 E.L. DISEASE - EA EMPLOYE 1,000,D00 E.L. DISEASE -POLICY LIMB 1,OOQ000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) City of Santa Ana, its officers, employees, agents, volunteers & representatives are named as Additional Insured on the General Liability with respects to the operations of the named insured per the attached endorsement form CG D411 04 08. Insurance is primary and non-contributory per attached policy form CG T1 00 0219. City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE REPRESENTATIVE ACORD 25 (2016103) 01988-2015 ACORD The ACORD name and logo are registered marks of ACORD Rbk Management Malyst