LUTHERAN SOCIAL SERVICES OF SOCAL (2)

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Digitally signed by Tod Ofl Pierson ersmDare: 20210e,017:10ne �07 no ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MM DD YY Y 1 ki 07/11/2022 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 endorsement(s). PRODUCER CONTACT NAME: A DeJohn Carriage Trade Insurance Agency, Inc. PHONE (516) 358-5600 F^x (516) 358-5656 AIC No Bell. C.No 99 Tulip Avenue ADOREss: AD eJohnQCardageTradelnsurance.com Stine 404 INSURER(S) AFFORDING COVERAGE NAIC k INSURER A: Wesco Insurance Co. 25011 Floral Park NY 11001 INSURED INSURER B Lutheran Social Services Of Southern California INSURER C: 999 Town and Country Rd INSURER 0: Ste 100 INSURER E: Orange CA 92868 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2271123659 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ADOLBUBR INSD MD POLICY NUMBER POLICY EFF (MMA)DtYYYYJ POLICY EXP IMMIDDIFYYYY)LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE © OCCUR EACH OCCURRENCE $ 1.000.000 DAMAGETGRENIED PREMISES Eaoccunence S 100,000 MED EXP Any one person S 5,000 PERSONAL a ADV INJURY $ 1,000,000 A Y Y WPP186062502 07/01/2022 07/01/2023 GEN'LAGGREGATE LIMITAPPLIES PER: x POLICY ❑ JECT PRG ❑ LOG GENERALAGGREGATE $ 3,000,000 PRODUCTS -COMP/OPAGG $ 3,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUIDS WPP186062502 07/01/2022 07/01/2023 BODILY INJURY (Per acdtlen0 $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per xdtlent $ S X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3.000,000 A EXCE35�L/IAB CLAIMS -MADE WUM186635202 07/01/2022 07/01/2023 DED RETENTION S 10,006 WORKERS COMPENSATION AND EMPUTE ANDEMPLOYERS'LU\BILITY yIN PER OTH- STAT ER E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUUVE El IM OFFICEREMBER EXCLUDED? EL. DISEASE - EA EMPLOYEE S (Mandatory in NH) I( yes, describe antler E.L. DISEASE -POLICY LIMIT $ DESCRI PTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be amended H more space is required) City of Santa Ana, officers, agents, employees, and volunteers are included as Additional Insureds as with respect to work performed by the Named Insured as required by written contract, agreement, or memorandum of understanding. Such insurance as is afforded by this policy shall be Primary, and any insurance carried by City shall be excess and noncontributory. Certificate of Insurance shall provide thirty (30) day prior written notice of Cancellation. City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORRED REPRESENTATIVE Rbk Mat>.genotl IXMtlm Ib:vlEwm 6 AIroRwBJ Br CA 92702 �} %du D(d'tJdN 9)1988.2015 ACORD ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD