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CERTIFICATE OF LI
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND
<br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITU
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of t
<br />this certificate does not confer rights to the certificate holder in Ileu of s
<br />PRODUCER
<br />Arthur J. Gallagher Risk Management Services, LLC
<br />18201 Von Karman Ave
<br />Suite 200
<br />Irvine CA 92612
<br />INSURED
<br />Thomas House Temporary Shelter
<br />PO Box 2737
<br />Garden Grove CA 92842
<br />ABILITY INSURANCE DATEJMMIDDIYYYY)
<br />11/8/2024
<br />Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
<br />EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />TE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />he policy, certain policies may require an endorsement. A statement on
<br />uch endorsement(s).
<br />NANEpCT Julie Fernandez
<br />PHONE FA . 949-349-9821 c No :949-349-9987
<br />E-MAIL ESS• Julle Fernandez a' .com
<br />INSURERS AFFORDING COVERAGE NAIC#
<br />INSURERA: Wesco Insurance COm an 25011
<br />INSURER B : Service American Indemnl!y Company 39152
<br />INSURER C: Security National Insurance Companv 19879
<br />INSURER D : Arch Insurance Company 11150
<br />INSURER E :
<br />INSURER F:
<br />-- -^ 1 • --- v %r rrra.n I c Imulvimcm- 141 lOZd3'13 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 ADOL SUBR
<br />LTR TYPE OF INSURANCE 11= Wvo POLICY NUMBER POLICY EFF POLICY EXP
<br />MMIDDIYYYY MM7pD1YYYY LIMITS
<br />C X COMMERCIAL GENERAL LIABILITY SPPI821824 10/3/2024 1013/2G25 EACH OCCURRENCE $1,000,000
<br />CLAIMS -MADE � OCCUR DAMAGE 7 RENTED
<br />_PREMISES Ea occurrence $100,000
<br />MED EXP (Any one arson) $ 5,000
<br />PERSONAL A ADv INJURY $ 1,000,000
<br />GEN'LAGGRFGATELIMITAPPLIESPER: GENERAL AGGREGATE $3,000,000
<br />X PRO- ❑
<br />LOC
<br />JECT
<br />PRODUCTS-COMPlOPAGG
<br />POLICY ❑ $3,000,D00
<br />OTHER: $
<br />C AUTOMOBILE LIABILITY SPPI822-167 00 10/3/2024 10/312025 (Ea eBBINEDiSINGLE LIMIT $1,OOQ000
<br />ANY AUTO OWNED SCHEDULED BODILY INJURY (Per person) $
<br />AUTOS ONLY AUTOS BODILY INJURY (per accident) $
<br />X HIRED X NON -OWNED Palo-
<br />ROYDAMgG£
<br />AUTOS ONLY AUTOS ONLY Per accident $
<br />$
<br />A X UMBRELLA LIAB X OCCUR WUM182911805 10/3/2024 10/312025 EACH OCCURRENCE $1,000,000
<br />EXCESS LIAB CLAIMS -MADE
<br />AGGREGATE $1,000,000
<br />DED I X I RETENTION$
<br />8 WORKERS COMPENSATION SAT1S0394904 PER OTH- $
<br />AND EMPLOYERS` LIABILITY 10/112024 10/1/2025 X STATUTE ER
<br />ANYPROPRIETORIPARTNERIEXECUTIVE YIN
<br />OFRCERWEMBEREXCLUDED? ❑ NIA E.L-EACH ACCIDENT $1,000,000
<br />(Mandatory in NHI
<br />E.L, DISEASE - EA EMPLOYEE $ 1,000,000
<br />under
<br />If yes, describeunder
<br />DESCRIPTION OF OPERATIONS below E.L. DISEASE . POLICY LIMIT $ 1,000,000
<br />C Scclal Services Prof, LiablF&O 8PP1821824 10/3/2029 101312D25 Each IncldenVA
<br />C Sexual or Physical Abuse 99 $1 M 1$3M
<br />17 Executive Package- See below SPP1821824 10/312024 10/3/2025 Each Incldent/Agg $1 M 1$3M
<br />N FP012112207 11/23/2023 1112W2024
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />Executive Package - 11/23/2024-1112312025 Policy#NFP012112207
<br />Director &Officers & Employment Practices Liability:
<br />Limit of Liability: $1,000,000 Deductible $5,000
<br />Fiduciary;
<br />Limit Of Liability; $250,000 Deductible $0
<br />CERTIFICATE HOLDER — 1-1 , A --
<br />Proof of Insurance
<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 />AUTHORIZED F
<br />O 1088-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />-- -^ 1 • --- v %r rrra.n I c Imulvimcm- 141 lOZd3'13 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 ADOL SUBR
<br />LTR TYPE OF INSURANCE 11= Wvo POLICY NUMBER POLICY EFF POLICY EXP
<br />MMIDDIYYYY MM7pD1YYYY LIMITS
<br />C X COMMERCIAL GENERAL LIABILITY SPPI821824 10/3/2024 1013/2G25 EACH OCCURRENCE $1,000,000
<br />CLAIMS -MADE � OCCUR DAMAGE 7 RENTED
<br />_PREMISES Ea occurrence $100,000
<br />MED EXP (Any one arson) $ 5,000
<br />PERSONAL A ADv INJURY $ 1,000,000
<br />GEN'LAGGRFGATELIMITAPPLIESPER: GENERAL AGGREGATE $3,000,000
<br />X PRO- ❑
<br />LOC
<br />JECT
<br />PRODUCTS-COMPlOPAGG
<br />POLICY ❑ $3,000,D00
<br />OTHER: $
<br />C AUTOMOBILE LIABILITY SPPI822-167 00 10/3/2024 10/312025 (Ea eBBINEDiSINGLE LIMIT $1,OOQ000
<br />ANY AUTO OWNED SCHEDULED BODILY INJURY (Per person) $
<br />AUTOS ONLY AUTOS BODILY INJURY (per accident) $
<br />X HIRED X NON -OWNED Palo-
<br />ROYDAMgG£
<br />AUTOS ONLY AUTOS ONLY Per accident $
<br />$
<br />A X UMBRELLA LIAB X OCCUR WUM182911805 10/3/2024 10/312025 EACH OCCURRENCE $1,000,000
<br />EXCESS LIAB CLAIMS -MADE
<br />AGGREGATE $1,000,000
<br />DED I X I RETENTION$
<br />8 WORKERS COMPENSATION SAT1S0394904 PER OTH- $
<br />AND EMPLOYERS` LIABILITY 10/112024 10/1/2025 X STATUTE ER
<br />ANYPROPRIETORIPARTNERIEXECUTIVE YIN
<br />OFRCERWEMBEREXCLUDED? ❑ NIA E.L-EACH ACCIDENT $1,000,000
<br />(Mandatory in NHI
<br />E.L, DISEASE - EA EMPLOYEE $ 1,000,000
<br />under
<br />If yes, describeunder
<br />DESCRIPTION OF OPERATIONS below E.L. DISEASE . POLICY LIMIT $ 1,000,000
<br />C Scclal Services Prof, LiablF&O 8PP1821824 10/3/2029 101312D25 Each IncldenVA
<br />C Sexual or Physical Abuse 99 $1 M 1$3M
<br />17 Executive Package- See below SPP1821824 10/312024 10/3/2025 Each Incldent/Agg $1 M 1$3M
<br />N FP012112207 11/23/2023 1112W2024
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />Executive Package - 11/23/2024-1112312025 Policy#NFP012112207
<br />Director &Officers & Employment Practices Liability:
<br />Limit of Liability: $1,000,000 Deductible $5,000
<br />Fiduciary;
<br />Limit Of Liability; $250,000 Deductible $0
<br />CERTIFICATE HOLDER — 1-1 , A --
<br />Proof of Insurance
<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 />AUTHORIZED F
<br />O 1088-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />Proof of Insurance
<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 />AUTHORIZED F
<br />O 1088-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
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