|
<br />DATE (MM/DD/YYYY)
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />12/04/2025
<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 />CONTACT
<br />PRODUCER Certificate Issuance Team
<br />NAME:
<br />FAX
<br />PHONE
<br />Comprehensive Insurance Services(949) 709-8800
<br />(A/C, No):
<br />(A/C, No, Ext):
<br />E-MAIL
<br />26429 Rancho Parkway Southjeremy@thecomprehensiveinsurance.com
<br />ADDRESS:
<br />Suite 120
<br />INSURER(S) AFFORDING COVERAGENAIC #
<br />Lake ForestCA92630Nonprofits Insurance Alliance of California10023
<br />INSURER A :
<br />INSURED State Compensation Insurance Fund35076
<br />INSURER B :
<br />Orange County Children's Therapeutic Arts Center
<br />INSURER C :
<br />2215 N. Broadway
<br />INSURER D :
<br />INSURER E :
<br />Santa AnaCA92706
<br />INSURER F :
<br />All
<br />COVERAGESCERTIFICATE NUMBER: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 />ADDLSUBR
<br />INSRPOLICY EFFPOLICY EXP
<br />TYPE OF INSURANCELIMITS
<br />POLICY NUMBER
<br />LTR(MM/DD/YYYY)(MM/DD/YYYY)
<br />INSDWVD
<br />COMMERCIAL GENERAL LIABILITY 1,000,000
<br />EACH OCCURRENCE$
<br />DAMAGE TO RENTED
<br />500,000
<br />CLAIMS-MADEOCCUR$
<br />PREMISES (Ea occurrence)
<br />20,000
<br />MED EXP (Any one person)$
<br />AYY01-CP-0009201-01-1212/21/202512/21/20261,000,000
<br />PERSONAL & ADV INJURY$
<br />3,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$
<br />PRO-
<br />3,000,000
<br />POLICYLOCPRODUCTS - COMP/OP AGG$
<br />JECT
<br />$0 Deductible
<br />$
<br />OTHER:
<br />COMBINED SINGLE LIMIT
<br />AUTOMOBILE LIABILITY 1,000,000
<br />$
<br />(Ea accident)
<br />ANY AUTOBODILY INJURY (Per person)$
<br />OWNEDSCHEDULED
<br />A01-CP-0009201-01-1212/21/202512/21/2026
<br />BODILY INJURY (Per accident)$
<br />AUTOS ONLYAUTOS
<br />HIREDNON-OWNEDPROPERTY DAMAGE
<br />$
<br />(Per accident)
<br />AUTOS ONLYAUTOS ONLY
<br />$0 Deductible
<br />$
<br />UMBRELLA LIAB 1,000,000
<br />OCCUREACH OCCURRENCE$
<br />A EXCESS LIAB 01-UB-0009201-01-0312/21/202512/21/20261,000,000
<br />CLAIMS-MADEAGGREGATE$
<br />$0 Deductible
<br />DEDRETENTION$$
<br />PEROTH-
<br />WORKERS COMPENSATION
<br />STATUTEER
<br />AND EMPLOYERS' LIABILITY
<br />Y / N
<br />1,000,000
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />E.L. EACH ACCIDENT$
<br />BN N / A Y9255171-2506/05/202506/05/2026
<br />OFFICER/MEMBER EXCLUDED?
<br />1,000,000
<br />(Mandatory in NH)
<br />E.L. DISEASE - EA EMPLOYEE$
<br />If yes, describe under
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$
<br />$1,000,000/1,000,000Aggregate/Occurr
<br />Social Service Professional Liability
<br />A01-CP-0009201-01-1212/21/202512/21/2026$3,000,000/1,000,000Aggregate/Occurr
<br />Improper Sexual Conduct Liability
<br />$0 Deductible
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / 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 automatically per written contract or agreement
<br />per attached endorsement CG2010, CG 2037. 30 day notice of cancellation with 10 day notice of cancellation for non-payment of premium per policy
<br />provision. Waiver of Subrogation applies per attached endorsement NIA-026B GL 01 25 & 10217. This insurance is Primary and Non-contributory per
<br />attached endorsement NIA-061B GL 01 25
<br />Ejhjubmmz!tjhofe!
<br />Uv!Usbo!
<br />cz!Uv!Usbo!
<br />Ohvzfo!
<br />Ohvzf
<br />Ebuf;!
<br />3137/12/25!
<br />o
<br />1:;52;41!.19(11(
<br />CzUvUsboOhvzfobu:;52bn-Kbo25-3137
<br />CERTIFICATE HOLDERCANCELLATION
<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 />City of Santa Ana
<br />ATTN: Audrey Goodson
<br />AUTHORIZED REPRESENTATIVE
<br />801 W Civic Center Dr Ste 200
<br />Santa AnaCA92701
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD
<br />
<br />
|