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Digitally signed ACCORD® CERTIFICATE OF LIABILITY INSU&ngie by DD/YYYY) 7/18/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE C_R �� DER..THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTEE�11IEicP1tTJI�Ili`SSfv��191OKIZ BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT B REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. ' ' IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INJURED 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 endorsement(s). PRODUCER CONTACT NAME: Arthur J. Gallager & Co. Arthur J. Gallagher & Co. Insurance Brokers of CA, Inc. LIC #0726293 PHONE FAX vC No Ext : 949-349-9800 vc, No): 949-349-9900 ADDRESS: 18201 Von Karman Ave Suite 200 INSURER(S) AFFORDING COVERAGE NAIC# Irvine CA 92612 wsURERA: California Charter Schools JPA INSURED CALICHA-03 INSURERB: Safety National Casualty Corporation 15105 California Charter Schools Joint Powers Authority Nova Academy INSURERC: Scottsdale Insurance Company 41297 INSURERD: 500 W. Santa Ana Blvd Santa Ana CA 92701 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER:72391117 REVISION NUMBER: 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY CCSJPA MOC 2022-23 7/1/2022 7/1/2023 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence)$ 1,000,000 X MED EXP (Any one person) $ 10,000 Sexual Abuse* X Educators E&O PERSONAL & ADV INJURY $ Included GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- POLICY JECT ❑ LOC X PRODUCTS - COMP/OP AGG $ 2,000,000 Crime $ 1,000,000 OTHER: A AUTOMOBILE LIABILITY CCSJPA MOC 2022-23 7/1/2022 7/1/2023 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED X SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION $ $ A B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N CCSJPA MOC 2022-23 SP 4066643 7/1/2022 7/1/2022 7/1/2023 7/1/2023 X PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICE R/M EMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Employment Practices(Claims-Made) EKS3435051 7/1/2022 7/1/2023 Each Wrongful Act/Agg $ 1,000,000 A Directors & Officers(Claims-Made) Fiduciary(Claims-Made) CCSJPA MOC 2022-23 7/1/2022 7/1/2023 Each Wrongful Act/Agg Each Wrongful Act/Agg $ 1,000,000 $ 1 ,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) *Sexual Abuse Coverage is on Claims Made basis. Evidence of Coverage pursuant to and subject to policy terms, definitions, conditions and exclusions as respects: Event Date: July 1, 2022 — June 30, 2025. Waiver of subrogation is included with respects to General Liability. This insurance is primary and all other insurance is non-contributory. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana -Att: Emy Frankston 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 IZISIZ kluagment DlRR810R REVIEWED & APPROVEDBY: © 1988-2015 ACORD °( ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Risk Management specialist