|
EXHIBIT 1
<br /> AC RID® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
<br /> li 1 12/20/2024
<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 NAME: Certificate Issuance Team
<br /> Comprehensive Insurance Services PHONE (949)709-8800 FAX
<br /> (AIC,No,Ext: fA
<br /> /C
<br /> .
<br /> No):
<br /> 26429 Rancho Parkway South L MPJL ADDRESS: jeremy@ p thecom rehensiveinsurance.com
<br /> Suite 120 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Lake Forest CA 92630 INSURERA: Nonprofits Insurance Alliance Of California 10023
<br /> INSURED INSURER B: State Compensation Insurance Fund 35076
<br /> Orange County Children's Therapeutic Arts Center INSURER C:
<br /> 2215 N.Broadway
<br /> INSURER D
<br /> INSURER E:
<br /> Santa Ana CA 92706 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: All REVISION NUMBER:
<br /> THIS IS TO CERTIFYTHATTHE 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 I A001.UUHR POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD MM/DO LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE �OCCUR ,..EMI L rtLrvcu 500,000
<br /> PREMISES(Ea occurrence] $
<br /> MED EXP(An one person) $ 20,000
<br /> A Y Y 2024-09201 12121/2024 12/21/2025 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 3,000,000
<br /> POLICY ❑PRO-
<br /> POLICY LOC PRODUCTS-COMP/OPAGG $ 3.000,000
<br /> JRO-
<br /> OTHER: $O Deductible $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> _(Ea accident)
<br /> ANYAUTO BODILY INJURY(Per person) $
<br /> A ~ OWNED SCHEDULED Y 2024-09201 12/21/2024 12121/2025 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> X AUTOS ONLY H
<br /> AUTOS ONLY jeer accident) $
<br /> $0 Deductible $
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000
<br /> A EXCESS LIAB CLAIMS-MADE 2024-09201-UMB 12/21/2024 12/21/2025 AGGREGATE $ 1,000,000
<br /> DED I I RETENTION$ 10000
<br /> WORKERS COMPENSATION XI PER STATUTE ERH SO Deductible
<br /> AND EMPLOYERS'LIABILITY
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000
<br /> B OFFICERIMEMBEREXCLUDE07 N/A Y 9255171-24 06/05/2024 06105/2025
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE g 1,000,000
<br /> it yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> $1'000,000/1.000,000 Aggregate/Occurr
<br /> A Social Service Professional Liability 2024-09201 12/2112024 12/21/2025 $3,000,000/1,000,000 A
<br /> Improper Sexual Conduct Liability ggregatelOccurr
<br /> $0 Deductible
<br /> DESCRIPTION OF OPERATIONS;LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> The City of Santa Ana,its officers,officials,employees,and volunteers are included as Additional Insured per attached endorsement CG2026&NIAC E131&
<br /> NIAC Al. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured,such insurance as is afforded by
<br /> this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of The City of Santa Ana,its officers,
<br /> officials,employees,and volunteers per attached endorsement NIAC E61. 30 day notice of cancellation with 10 day notice of cancellation for non-payment
<br /> of premium per policy provision. See attached forms list. Waiver of Subrogation applies per attached endorsement NIAC E26&10217.
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION By Cynth/a Mora at 10:31 am, Dec 23;2024
<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 /> Attn:Audrey Goodson
<br /> 801 W.Civic Center Dr Ste 200 AUTHORIZED REPRESENTATIVE
<br /> 1 Santa Ana CA 92701u. �"`"
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
|