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ACORO® CERTIFICATE OF LIABILITY INSURANCE
<br />ls.�
<br />DATE(MM/DDNYYY)
<br />10/22/2024
<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
<br />CONAE MIAdam Muth
<br />PHONE (415) 754-3635 ac No
<br />Newfmnt Insurance Services, LLC
<br />450 Sansome Street
<br />E-MAILSS, adam.muth@newfmnt.com
<br />INSURER B AFFORDING COVERAGE
<br />NAIC #
<br />Suite 300
<br />INSURERA: Alliance of Nonprofits for Insurance, Risk Retention l
<br />10023
<br />San Francisco CA 94111
<br />INSURED
<br />INSURERB: State Compensation Insurance Fund
<br />35076
<br />Asian American Senior Citizens Service Center Inc (AASCSC)
<br />INSURER C : Underwriters at Lloyd's, London
<br />INSURER D :
<br />INSURER E:
<br />850 North Birch Street
<br />INSURERF:
<br />Santa Ana CA 92701
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE 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 />INSR
<br />LTR
<br />TYPE OF
<br />ADDL
<br />SUER
<br />POLICY NUMBER
<br />POLICYEFF
<br />MM/DDIYYW)
<br />POLICYEFP
<br />fMMIDOIfY`fYI
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$ SOO,000
<br />MED EXP (Any oneperson)
<br />$ 20,000
<br />PERSONAL a ADV INJURY
<br />$ 1,000,000
<br />A
<br />X
<br />X
<br />2024-01391
<br />06/05/2024
<br />06/05/2025
<br />GEN'L
<br />X
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY PET F7 LOC
<br />GENERALAGGREGATE
<br />$ 3,000,000
<br />PRODUCTS - COMP/OPAGG
<br />$ 3,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMITWe
<br />$ 1,000,000
<br />BODILY INJURY (Per Wrean)
<br />$
<br />ANY AUTO
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />2024-01391
<br />06/05/2024
<br />06/05/2025
<br />BODILY INJURY accident Per
<br />( )
<br />$
<br />X
<br />HIRED NON -OWNED
<br />AUTOS ONLY X AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Per accitlent
<br />$
<br />$
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LIAB
<br />o.:M5-MADE
<br />DED RETENTION$
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />of ICERMETORPA TNERIE?ECUTIVE ❑
<br />DED
<br />(Mandator, in NH)
<br />X
<br />9100741-24
<br />10/01/2024
<br />10/01/2025
<br />PER OTF4
<br />X STATUTE ER
<br />E.L. EACH
<br />E.EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE -EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, descnbe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />C
<br />Cyber Liability
<br />ESN0240065424
<br />09/01/2024
<br />09/01/2025
<br />Limit
<br />Deductible
<br />$1,000,000
<br />$2,500
<br />DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101, Addidanal Remarks Schedule, maybe attached if more space is required)
<br />(Insurer A) -Sexual Misconduct, Physical Abuse, and Molestation Liability - 2024-01391 - (06/05/2024 - 06/05/2025) - Each Claim: $1,000,000 ; Aggregate
<br />$1,000,000
<br />(Insurer A) -Professional Liability- 2024-01391 - (06/05/2024 - 06/05/2025) - Each Event: $1,000,000 Aggregate : $2,000,000
<br />City of Santa Ana is included as additional insured on General liability policy per the attached form. General liabilitycoverage is primary and non-contributory
<br />per the attached form. Waiver of Subrogation applies to General Liability and Worker's C
<br />APPROVED
<br />CERTIFICATE HOLDER CANC By Cynthia Mora at 10:35 am, Dec 10, 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 />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza
<br />Santa Ana CA 92701
<br />9)1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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