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A�® CERTIFICATE OF LIABILITY INSURANCE rATE 3/14/202(MMIDDfYYYY)
<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
<br /> Savannah NAME:
<br /> PHONE FAX
<br /> 22 Barnard Street AIC No
<br /> Suite 200 A DRIESS: gssolutions@palmerandcay.com
<br /> Savannah GA 31401 INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:National Casualty Company 11991
<br /> INSURED GIRLSCO-85 INSURER B:Lexington Insurance Company 19437
<br /> Girl Scouts of Orange County
<br /> 9500 Toledo Way INSURER C:Granite State Insurance Company 23809
<br /> Suite 100 INSURER D:
<br /> Irvine CA 92618
<br /> INSURER E;
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:1029054499 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 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP
<br /> LTR POLICY NUMBER MMIDD/YYYY) (MMIDDIYYYYI LIMITS
<br /> B X COMMERCIAL GENERAL LIABILITY Y X AIP3450493501 10/1/2024 10/112025 EACH OCCURRENCE $1,000,000
<br /> DAMAGE TO RENTED
<br /> X
<br /> CLAIMS-MADE OCCUR PREMISES Ea occurrence)
<br /> ccurrence $1,000,000
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN1 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 3,000,000
<br /> POLICY JECTPRO a LOG PRODUCTS-COMP/OP AGG S3,000,000
<br /> OTHER: $
<br /> C AUTOMOBILE LIABILITY CA0442514221 10/1/2024 10/1/2025 COMBINED
<br /> tINED SINGLE LIMIT $1,000,000
<br /> Ea a
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED AUTOS ONLY- AUTOS BODILY INJURY(Per accident) $
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $
<br /> DED RETENTION$ $
<br /> A WORKERS COMPENSATION Y WCC330125A 12/18/2024 12118/2025 X STATUTE OERH
<br /> AND EMPLOYERS'LIABILITY Y 1 N
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBEREXCLUDED? N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> B Sex Abuse&Molestation AIP3450493501 10/1/2024 10/1/2025 Per Occurrence 1,000,000
<br /> Aggregate 2,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Santa Ana,its officers,officials,employees,and volunteers are named as Additional Insured on the general liability policy with respect to the use of its
<br /> premises for Girl Scout activities of the insured Girl Scout Council.Waiver of Subrogation applies as required by written contract. Coverage is Primary and
<br /> Non-Contributory.
<br /> Tu Tran Digitally Tu Tran Nguyen signed by APPROVED
<br /> Date:2025.04.29
<br /> Nguyen 09:07:23.07'00' By Tu Tran Nguyen at 9:06 am,Apr 29,2025
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Santa Ana,Attention: Executive Director,
<br /> Community Development Agency, AUTHORIZED R�EEPPRESENTATIVE
<br /> 20 Civic Center Plaza M-25, e\�
<br /> Santa Ana, CA 92701.
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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