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ACC) CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
<br /> 02/21/2025
<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 /> PRODUCER CONTACT Certificate Issuance Team
<br /> NAME:
<br /> Comprehensive Insurance Services PNE (949)709-8800
<br /> AIC HO Ext:No FAR
<br /> A)C,No):
<br /> 26429 Rancho Parkway South E-MAIL jerem th rehensiveinsurance.com
<br /> ADDRESS: Y ecom p
<br /> Suite 120 INSURER(5)AFFORDING COVERAGE NAIC#
<br /> Lake Forest CA 9263D INSURERA: Nonprofits Insurance Alliance of California 10023
<br /> INSURED INSURER B: State Compensation Insurance Fund 35076
<br /> America On Track INSURER C
<br /> 600 W.Santa Ana Blvd. INSURER D
<br /> Ste.710
<br /> INSURER E
<br /> Santa Ana CA 92701 INSURER F
<br /> COVERAGES CERTIFICATE NUMBER: CL2482907116 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 PER10D
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAYBE 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 TYPE OF INSURANCE POLICY EFF POLICY EXP
<br /> LTR INSD WVD POLICYNUMBER MMfDD1YYYY) [MMIDDffYYYJ LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,01][0,000
<br /> GLAIMSMADE ❑X OCCUR ° 500,000
<br /> PREMISES Ea occurrence $
<br /> MED EXP(Any one perscn) $ 20,000
<br /> A Y Y 2024-06180 09/01/2024 09/01/2025 PERSONAL&AOV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE $ 3,000,000
<br /> POLICY ❑ PRO 1
<br /> JECT TOO PRODUCTS-COMPIOPAGG $ 3,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea accident
<br /> X ANYAUTO BODILY INJURY(Per person) $
<br /> A OWNED SCHEDULED Y Y 2024-06180 09/01/2024 09/01/2025 BODILY INJURY(Per accident) S
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE S
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> S
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 4,000,000
<br /> A EXCESS LIAB CLAIMS-MADE 2024-06180-UMB 09/01/2024 09/01/2025 AGGREGATE s 4,000,000
<br /> DED I I RETENTION 5 S
<br /> WORKERS COMPENSATION PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y1N X STATUTE ER
<br /> ANY PROPRIETOWPARTNERIEXECUTIVE E.L.EACH ACCIDENT S 1,000,000
<br /> B OFFICER/MEMBEREXCLUE NlA Y 9330492-25 01l0112025 01f0112026
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000
<br /> If yes,describe under i3OD0,D00
<br /> DESCRIPTION OF OPERATIONS baIow E.L.DISEASE-POLICY LIMIT 5
<br /> Improper Sexual Conduct Liability Social $2,000,00011,000,000 Aggregate/Ea Clm
<br /> A Service Professional Liability 2024-06180 09/01/2024 09101/2025 $2,000,00011,000,000 Aggregate/OCCur
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
<br /> City of Santa Ana,officers,agents,employees,and volunteers are named as additionally insured on this policy pursuant to written contract,agreement,or
<br /> memorandum of understanding per attached endorsement CG2026.Such insurance as is afforded by this policy shall be primary,and any insurance carried
<br /> by City shall be excess and noncontributory per attached endorsement NIAC E61 &NIAC Al. 30 day notice of cancellation with 10 day notice of
<br /> cancellation for non-payment of premium per policy provision. Waiver of Subrogation applies per attached endorsements NIAC E26,CA0444&10217
<br /> Tu Tran DigiraNysignedhy nAPPROVED
<br /> T.Tran Nguyen
<br /> Nguyen Date:2025.02.2i
<br /> 3:5:�-aa� Tran Nguyen at 1:56 pm, Feb 21, 2025
<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 /> Community Development Agency
<br /> 20 Civic Center Plaza M-25 AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701ra »"
<br /> 1
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<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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