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v l I l [L I, I I pate: 2022.03.30105 .l7 07-W ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (NVDDrM 03/23/22 PRODUCER CASPIAN INSURANCE SERVICES INC P.O. BOX 5508 SHERMAN OAKS CA 91413 TELEPHONE (818) 783-8385 FAX (818) 783-8360 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED NATIONAL POLYTECHNIC COLLEGE, INC. 4105 E. SOUTH STREET LAKEWOOD CA 90712 INSURER A: SCOTTSDALE INSURANCE CO. INSURER B: INSURER C: INSURER D: NSURER E: 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR L R TYPE OF INSURANCE POLICYNUMBER POUCYEFFECTIVE DATE MM 0 POLICY EXPIRATION O T D LIMITS A GENERALUASIUTY X COMMERCIAL GENERAL LIABILITY CLAIMS MADEOCCUR CPS7438793 09/12/21 ' 09/12/22 EACH OCCURRENCE $ 2000000 FIRE DAMAGE (Any cnefee) $ 100000 MED EXP Any one person) $ 5000 PERSONAL&ADV INJURY $ 2000000 GENERAL AGGREGATE $ 3000000 GENT AGGREGATE UMR APPLIES PER: POLICY JE� LOC PRODUCTS-COMP/OP AGO $ 20 00000 AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE UMR (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per acciden) $ PROPERTY DAMAGE (Per awMent) $ GARAGE UABILITY ANY AUTO AUTO ONLY -EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGO $ $ EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABIUTY WCSTATU- OTH- ORY LIMITS ER E.L. EACH ACCIDENT Is E.L DISEASE -EA EMPLOYEE I $ E.L.DISEASE-POUCYUMIT $ OTHER DESCRIPTION OF OPERATIONSILOCATIONSPTEHICLES/EXCWSI ONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CLASSES ON: MEDICAL ASSISTANT, HEMODIALYSIS TECHNICIAN, PHLEBOTOMY TECHNICIAN, MRI TECHNOLOGIST, DIAGNOSTIC MEDICAL SONOGRAPHY, CARDIOVASCULAR SONOGRAPHY AND HVAC-R" "THE CITY OF SANTA ANA, ITS OFFICERS, OFFICIALS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED PER ATT. BLANKET A/I ENDORSEMENT GLS-150S AND CG 20 01 12 19". "SCHEDULE OF FORMS AND ENDORSEMENTS ARE ATTACHED" CERTIFICATE HOLDER CITY OF SANTA ANA RISK MANAGEMENT DIVISION 20 CIVIC CENTER PLAZA SANTA ANA CA 92702 ACORD SHOULDANYOFTHEASOVE DESCRIBED POLICIES BECANCELLED BEFORETHE EXPIRATION DATETHEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THFIIEFT, BUT FALURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABIL OF ANY REPRESENTATIVES. .a, limkMvwp, dDM,ie3, T-HORI2EDREPRESENTATIVE RieEV &APm BY: '' %bu Z%inJort KN, M[ragmm[ Oniral Ai Ae