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A� O`er CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/07/2023 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 ma require an endorsement. A statement on this certificate does not confer rights to the certificate holde - in e r PRODUCER NA AC Ikki Evaniuck ms &Associatellnsurance B ers Acev Ext: (800) 578-8802 a/c, No: (818) 449-9321 L e�n e 0 4 Q A c e v e d o E-MAIL nevaniuck@pomsassoc.com 57 �arTbg�e'�S Date• IN U ER( ) AGE NAIC# Woodland Hills CA 9136 MSURERA: •Nonprofits Ins. Alliance of CA (NIAC) 160 INSURED NSURER B Working Wardrobes ForA New Start INSURER C : 2000 E. McFadden Ave INSURER D : Suite 100 INSURER E : Santa Ana CA 92705 INSURER F COVERAGES CERTIFICATE NUMBER: 23-24 GLAD UMB 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 INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREM SES Ea o.urrrence $ 500,000 MED EXP (Any one person) $ 20,000 PERSONAL &ADV INJURY $ 1,000,000 A Y Y 2023-49231 09/17/2023 09/17/2024 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 El PRO JECT LOC PRODUCTS-COMP/OPAGG 2,000,000P1 $POLICY Liquor Liability - Common $ 1,000,000 OTHER: AUTOMOBILE LIABILITY 56*H3rNED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y Y 2023-49231 09/17/2023 09/17/2024 BODILY INJURY (Pe r accide nt) $ X PROPERTY DAMAGE Per accident $ HIRED �/ NON -OWNED AUTOS ONLY /� AUTOS ONLY Uninsured Motorist $ 1,000,000 X UMBRELLA LIAB X OCCUR EACHOCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 A EXCESS LAB CLAIMS -MADE 2023-49231-UMB 09/17/2023 09/17/2024 DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ElN OFFICER/MEMBER EXCLUDED? /A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Improper Sexual Conduct & Physical Abuse 2023-49231 09/17/2023 09/17/2024 General Aggregate $2,000,000 Each Claim Limit $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of the Contractor including materials, parts, or equipment furnished in connection with such work or operations. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and noncontributory. Waiver of Subrogation applies per the attached forms. 30 day notice of cancellation (except for 10 day notice of cancellation for non-payment) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana Risk Management Division ACCORDANCE WITH THE POLICY PRO\ , Risk ManagementDiviaian 20 Civic Center Plaza E REVIEWED & APPROVED BY. AUTHORIZED REPRESENTATIVE 1"All IL av Santa Ana CA 92702 F c i 1 " Disk Management Specialist @ 1988-2015 ACOF ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD