|
� l A�ORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 12/20/2024
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
<br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT Certificate Issuance Team
<br /> NAME:
<br /> Comprehensive Insurance Services a/CNN Ext: (949)709-8800 FAX No):
<br /> 26429 Rancho Parkway South E-MAIL jeremy@thecomprehensiveinsurance.com
<br /> ADDRESS:
<br /> Suite 120 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Lake Forest CA 92630 INSURERA: Nonprofits Insurance Alliance of California 10023
<br /> INSURED INSURER B: State Compensation Insurance Fund 35076
<br /> Orange County Children's Therapeutic Arts Center INSURER C:
<br /> 2215 N.Broadway INSURER D:
<br /> INSURER E:
<br /> Santa Ana CA 92706 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: All REVISION NUMBER:
<br /> THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> ILTR INSD WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> TYPE OF INSURANCE (MM/DD/YYYY) (MM/DDIYYYY)
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> DAMAGE TO CLAIMS-MADE �OCCUR PREM SES(Ea oRENTED
<br /> lcur ante) $ 500,000
<br /> MED EXP(Any one person) $ 20,000
<br /> A Y Y 2024-09201 12/21/2024 12/21/2025 PERSONAL&ADV INJURY $ 1,000,000
<br /> MOTHER,
<br /> L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000
<br /> POLICY ❑ PRO FXLOC PRODUCTS-COMP/OPAGG $ 3'O170'1700
<br /> JECT $0 Deductible $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea accident
<br /> ANY AUTO BODI LY I NJ U RY(Per person) $
<br /> A OWNED SCHEDULED Y 2024-09201 12/21/2024 12/21/2025 BODI LY I NJ U RY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> X AUTOS ONLY AUTOS ONLY (Per accident)
<br /> H
<br /> $0 Deductible $
<br /> X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 1,000,000
<br /> A EXCESS LIAB CLAIMS-MADE 2024-09201-UMB 12/21/2024 12/21/2025 AGGREGATE $ 1,000,000
<br /> DED RETENTION $ 10000 $
<br /> WORKERS COMPENSATION X PER
<br /> STATUTE EORH $0 Deductible
<br /> AND EMPLOYERS'LIABILITY Y/N 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
<br /> B OFFICER/MEMBER EXCLUDED? NIA Y 9255171-24 06/05/2024 06/05/2025
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> $
<br /> Social Service Professional Liability 1,000,000/1,000,000 Aggregate/Occurr
<br /> A Improper Sexual Conduct Liability 2024-09201 12/21/2024 12/21/2025 $3,000,000/1,000,000 Aggregate/Occurr
<br /> $0 Deductible
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 1D1,Additional Remarks Schedule,may be attached if more space is required)
<br /> The City of Santa Ana,its officers,officials,employees,and volunteers are included as Additional Insured per attached endorsement CG2026&NIAC E131 &
<br /> NIAC Al. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured,such insurance as is afforded by
<br /> this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of The City of Santa Ana,its officers,
<br /> officials,employees,and volunteers per attached endorsement NIAC E61. 30 day notice of cancellation with 10 day notice of cancellation for non-payment
<br /> of premium per policy provision. See attached forms list. Waiver of Subrogation applies per attached endorsement NIAC E26&10217.
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION By Cynthia Mora at 10:31 am, Dec 23, 2024
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attn:Audrey Goodson
<br /> AUTHORIZED REPRESENTATIVE
<br /> 801 W.Civic Center Dr Ste 200
<br /> i
<br /> Santa Ana CA 92701 zh'"
<br /> @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
|