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CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) <br /> 5/27/2025 <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($), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ios)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 COW" <br /> Julie Fernandez E. <br /> Arthur J. Gallagher Risk Management Services, LLC PHONE FAx <br /> 18201 Von Karman Ave •949-349.9821 AIc NO:949-349-9967 <br /> Suite 200 F-MAILss: Julie Fernandez@ajg.com <br /> Irvine CA 92ti 12 INSURERS AFFORDING COVERAGE NAIL N <br /> License*oDs9293 INSURER A:Wesco Insurance Company 25011 <br /> INSURED THOMHOU-D2 INSURER B:Service American Indemnity Company3g152 <br /> Thomas House Temporary Shelter PO Box 2737 INSURER C:Security National Insurance Company 19879 <br /> Garden Grove CA 92842 INSURER o:Arch Insurance Company 11150 <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:227886967 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 /> EXCLJSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EPP POLICY EXP <br /> LTR POLICY NUMBER MMIDDIYYYY MMMDIYYYY LIMITS <br /> C X COMMERCIAL GENERAL LIABILITY Y Y SPP1821824 10/3/2024 10/3/2025 EACH OCCURRENCE $1,000,000 <br /> CLAIMS-MADE X OCCUR DAMAGE 0E TED <br /> PREMISES fEa occurrence $100.000 <br /> MED EXP(Any one parson) $5,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 <br /> X PRO_ <br /> POLICYJECT LOC PRODUCTS-CCMPIOPAGG $3,000,00o <br /> OTHER: $ <br /> C AUTOMOBILE LIABILITY Y Y SPP1822767 00 10/3/2024 10l3/2025 CO EQ QBI ot51NGLE LIMIT $1,004,000 <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY <br /> AUTOS ONLY AUTOS (Per accident) $ <br /> HIRED X NON-OWNED PROPERTY DAMAGE <br /> AJTOS ONLY AUTOS ONLY par accident <br /> XI $ <br /> $ <br /> A X UMBRELLAL1AB X OCCUR Y Y WUM182911805 10/3/2024 10/3/2025 EACH OCCURRENCE $1,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $1,00o,000 <br /> DED I X I RETENTION$i n nnn $ <br /> B WORKERS COMPENSATION SATIS0344904 10/1/2024 10/112025 X <br /> AND EMPLOYERS'LIABILITY YIN STATUTE aTRN <br /> ANYPRCPRIETOP4PARTNERIEXECUTIVE E.L.EACH ACCIDENT $1,000,000 <br /> OFFICERIMEMBEREXCLUDED? El NIA <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1.000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 <br /> C SooW Services Prof.Liab/E&O SPP1821824 10l312024 101312025 Each IncidenllAgg $1 M!$3M <br /> C SexualvePhysicalAbuse SPP1821824 10/3/2024 1013l2025 EachIncidentlAgg $1M/$3M <br /> O Executive Package-See below NFP012112208 11/23l2024 11/23/2025 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) <br /> Executive Package-11/23/2024-11123/2025 Policy#NFP01 21 1 2207 DigltallysIgned <br /> Director&Officers&Employment Practices Liability: TU Tran byTeTran <br /> Limit of Liability:$1,000,000 Deductible$5,000 rg yee <br /> N g uyeh Date:2025.06.24 <br /> Fiduciary: 15110-e7ac <br /> Limit of Liability:$260,000 Deductible$0 <br /> City of Santa Ana,Attention:Community Development Agency,Homeless Services,20 Civic Center Plaza,M25 Santa Ana,CA 92701 are lisred as additional <br /> insured <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 /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Attention: Community Development Agency, Homeless <br /> 20 Civic Center Plaza, M25 AUTHORIZED REPRESENTATIVE <br /> Santa Ana CA 92702 +; - <br /> , r ` <br /> ©1988-2015 ACORD CORPORATION. Ali rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />