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AC" CERTIFICATE OF LIABILITY INSURANCE I
<br /> DATE
<br /> 51$012 0 25YYY)
<br /> THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND ORALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING(NSURER(S),AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT- If the certificate holder is an ADDITIONAL INSURED,the policy(les)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 NAM✓; Steven Eddinger
<br /> Kraft Lake Insurance Agency Alfa NE Ext; (423)886-3123 FA AIC,No: (423)886-917
<br /> PO BOX 1426-Loc 1482 A DRESS: seddinger@farmersagent.com
<br /> Grand Rapids,MI 49501 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURERA: Philadelphia Insurance Companies 18068
<br /> INSURED INSURER B:
<br /> Stand Up For Kids INSURER C:
<br /> 200 Nelson Ferry Rd INSUReR o:
<br /> Ste B INSURER E
<br /> Decatur GA 30030 INSURER F
<br /> COVERAGES CERTIFICATE 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BYTHE 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 /> ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMfRO� MMI��Y� LIMITS
<br /> COMMERCIAL GENERAL LIABILITY $ 1,000,000
<br /> EACH OCCURRENCE
<br /> X CLAIMS-MADE EX OCCUR PREMISES Ea occurrence $ 100,000
<br /> A Y Y PHPK2568355-003 07/15/2024 07/15/2025 MED EXP(Any one person) $ 5,000
<br /> PERSONAL&ADVINJURY $ 1,000,000
<br /> GEN'LAGGREGATE LIMIT APPLIES PER., GENERAL AGGREGATE $ 3,000,000
<br /> X POLICY❑PEST- D LOC PRODUCTS-COMPIOPAGG $ 3,000,000
<br /> OTHER: ABUSIVE CONDUCT LIABILITY $ 1,000,000
<br /> AUTOMOBILE LIABILITY COMBINED SINGLELI MIT $ 1,OOa,00a
<br /> Ea accident
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> A OWNED SCHEDULED PHPK2558355-003 07115/2024 07/15/2025 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED P
<br /> NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Par aocidenl
<br /> X 08,09 $
<br /> X UMSRELLALIA13 NX
<br /> OCCUR EACH OCCURRENCE $ 3,000,000
<br /> A EXCESSLIAE CLAIMS-MADE PHUB885726-003 07/15/2024 07/18/2025 AGGREGATE $ 3,000,000
<br /> orzo I I RETENTION$ 10,000 $
<br /> WORKERS COMPENSATION PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN STATUT E ER
<br /> ANY PROPRIETORIPARTNERIEXECUTIVE ❑ E.L.EACH ACCIDENT $
<br /> OFFICEMEMBER EXCLUDED?
<br /> (Mandatory In Nil) E,L,DISEASE-FA EMPLOYEE $
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> Professional Liability PHPK2558355-003 07/15/2024 07115/2025 Each Professional Incident Limit $ 1,0001000
<br /> A Aggregate Urnit $ 3,000,000
<br /> Cybor Liability PHSDI841273-001 11/22/2024 11/22/2025 Aggregate Umit $ 1,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
<br /> "City of Santa Ana, its City Council, its officers, officials, employees, agents, and volunteers are named as additionally Insured on this
<br /> policy pursuant to written contract, agreement, or memorandum of understanding. Such Insurance as is afforded by this policy shall be
<br /> primary,and any insurance carried by City shall be excess and noncontributory."
<br /> Certificate holder Is an"Additional Insured"per the General Liability Deluxe Endorsement:Human Services(PI-GLD-HS)form attached to the policy.
<br /> 30-Days Notice of Cancellation,except for Non-Payment which is 1 G-Days Notice..
<br /> CERTIFICATE HOLDER. CANCELLATION
<br /> Digitallyslgned
<br /> City of Santa Ana TU Tran.byTuTran SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Attention:AudreyGoodsonpp I� Nguyen THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
<br /> INguyen Date:2025.06.93 ACCORDANCE WITH THE POLICY PROVISIONS,
<br /> 801 W Civic Center Drive,Suite 200 o9s2:32-6raa
<br /> Santa Ana,CA 92701
<br /> _ AUTHORIZED REPRESENTATIVE
<br /> APPROVED By 7Jralr Ngujren of 9 52;am Jun 03 20Z5
<br /> OO 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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