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TE <br /> AC R" CERTIFICATE OF LIABILITY INSURANCE DA51221202yYYY) <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR N EGATIVELY AM EN D,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 Lauren Justus <br /> NAME: <br /> Turner,Wood,&Smith Agency,Inc. PHON o xt t770)536.0161 FAX, <br /> Nei: (770)536-1283 <br /> 1515 Community Way E-MAIL lauren.justus@twsinsurance.com <br /> ADDRESS: <br /> PO BOX 1058 INSURER(S)AFFORDtNG COVERAGE NAIL# <br /> Gainesville GA 30503 INSURERA: Accident Fund Ins.Co.ofAmerica 10166 <br /> INSURED INSURER B: Wilted States Liability Ins,Co. 25895 <br /> Stand Up For Kids,Inc. INSURER C: <br /> 200 Nelson Ferry Rd INSURER D: <br /> Ste B INSURER E <br /> Decatur GA 30030 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE 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 /> LTR TYPE OF INSURANCE INSD VyYD POLICY NUMBER MMIDDIYYYY MMIDWYYYY LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> CLAIMS-MADE F7 OCCUR PREMISES JEa occurrence $ <br /> MEO EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GEN'LAGGREGATE LIMITAPPDES PEW GENERALAGGREGATE <br /> POLICY DPRO ❑LOC <br /> JECT PRODUCTS-COMPIOPAGO $OTHER $ <br /> AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANYAUTO BODILY INJURY tPer person) $ <br /> OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> UMBRELLALIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR HCLAIMS-MADE <br /> AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> WORKERS COMPENSATION X STA UTE 7T <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETOR)PARTNEWEXECUTIVE Y!N E.L.EACH ACCIDENT $ 1,000,000 <br /> A OFFICERIMEMBER EXCLUDED? l.N NIA Y AF WGP 100031316 03 06/2712024 D6127/2025 <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 /> D&O Each Claim $2,000,000 <br /> B Retention-$6,000 Each Claim Directors and Officers Liability ND01562545K 05/18/2025 05/1812020 EPL Each Claim $2,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is <br /> required) <br /> Waiver of Subrogation as required by Contract applies to Worker's Compensation per form WC000313(04-84), <br /> 30-Days Notice of Cancellation,except for Non-Payment which is 10-Days Notice.. <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Attn:Mishaun Watkins THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Santa Ana,CA 92702 <br /> AUTHORIZED REPRESENTATIVE <br /> v�i'UU'fX.:1•aS)7.� <br /> i <br /> O 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />