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FATE(MMIDDIYYYY) <br /> ACOR" CERTIFICATE OF LIABILITY INSURANCE <br /> 4/11/202610/2025 <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 Lockton Companies,LLC CONTACT <br /> NAME: <br /> DBA Lockton Insurance Brokers,LLC in CA PHONE FAX <br /> CA license#OF15767 (A/C,No Ext: A/C,No <br /> E-MAIL <br /> 8110 E Union Ave.,Ste.100 ADDRESS: <br /> Denver CO 80237 INSURER(S)AFFORDING COVERAGE NAIC# <br /> denver-cetts@lockton.com INSURER A:Houston Casualty Company 42374 <br /> INSURED Simple Therapy,Inc. INSURER B:Scottsdale Insurance Company 41 297 <br /> 1542844 Halycon Behavioral,LLC INSURER C:Continental Casualty Complmy 20443 <br /> 1080 Shaw Ave St 105 INSURER D:Ironshore Specialty Insurance Co 25445 <br /> Fresno CA 93711 <br /> INSURER E <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 19715405 REVISION NUMBER: XXXXXXX <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 SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD POLICY NUMBER MM/DDIYYW W MMIDD/ YY <br /> COMMERCIAL GENERAL LIABILITY NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX <br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED <br /> PREMISES Ea occurrence $ XXXXXXX <br /> MED EXP(Any one person) $ XXXXXXX <br /> PERSONAL&ADV INJURY $ XXXXXXX <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ XXXXXXX <br /> POLICY❑ PRO JECT ❑ LOC PRODUCTS-COMP/OP AGG $ XXXXXXX <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY NOT APPLICABLE COMBINED SINGLE LIMIT $ <br /> Ea accident XXXXXXX <br /> ANY AUTO BODILY INJURY(Per person) $ XXXXXXX <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS XXXXXXX <br /> HIRED NON-OWNED PROPERTY DAMAGE $ XrXrXrXrXrXrXr <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> $ XXXXXXX <br /> UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ XXXXXXX <br /> DED RETENTION$ $ XXXXXXX <br /> WORKERS COMPENSATION NOT APPLICABLE PER OTH- <br /> AND EMPLOYERS'LIABILITY STATUTE ER <br /> YIN <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ XXXXXXX <br /> OFFICER/MEMBER EXCLUDED? N I A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ XXXXXXX <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ XXXXXXX <br /> A Tech EO-Cyb N N HA25TG33676-02 7/1/2025 4/11/2026 $5M,Ret.$25k <br /> B XS Tech EO-Cyb EKS3580291 7/l/2025 4/11/2026 $5M xs$5M <br /> C DO/EPL/FTD 8019002204 4/11/2025 4/11/2026 $1 M/$1 M/$1 M <br /> D Mng Cr EO HC7CAB4HM9005 7/1/2025 4/11/2026 $1M Per Claim/$2M Agg <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER,APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERMS)REFERENCED. Digitally sig ed <br /> Cit of Santa Ana is included as an additional insured as respects to Mn Care E&O if required b written contract. Tu Tra n by Tu Tran <br /> Y P g 4 Y Nguyen <br /> Nguyen D01329207 O5 <br /> [APPROVED <br /> By Tu Tran Nguyen at 10:12 am,Sep 15,2025 <br /> CERTIFICATE HOLDER CANCELLATION See Attacrimetus <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 19715405 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> City 5 Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Attention: Human Resources Department f <br /> AUTHORIZED REPRESENTATNE <br /> 20 Civic Center Plaza , ' <br /> Santa Ana,CA 92702 <br /> ©1988-20i ACORD CORPGRATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />