COMMUNITY HEALTH INITIATIVE ORANGE COUNTY (4)

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A E(MMIDDIYYYY)G CERTIFICATE 4F LIABILITY INSURANCE AT1 2/1 312 024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Certificate Issuance Team NAME: Comprehensive Insurance Services AHr Ext: (949)709-8800 AIC,No 26429 Rancho Parkway South E-MAIL ADDRESS: Jeremy@thecomprehensiveinsurance.com Suite 120 INSURERS)AFFORDING COVERAGE NAIC N Lake Forest CA 92630 INSURERA: Nonprofits Insurance Alliance of California 10023 INSURED INSURER B: State Compensation Insurance Fund 35076 Community Health Initiative of Orange County INSURER C 1505 E.17th Street,Suite 108 INSURER D: INSURER E Santa Ana CA 92705 INSURER r: COVERAGES CERTIFICATE NUMBER: CL2410407160 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ALMUL hIJILIK POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ 500,000 MED EXP(Any one person) $ 20,000 A Y Y 2024-44927 10/15/2024 10/1512025 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATELIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO ® LOC PRODUCTS-COMPIOPAGG $ 2,000,000 JECT OTHER: $0 Deductible $ AUTOMOBILE LIABILITY COa acMBciINEDdent SINGLE LIMIT $ 1,000,000 E ANYAUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED 2024-44927 lOY15/2024 10/1512025 BODILY INJURY(Per accident) S AUTOS ONLY AUTOS X HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY X AUTOS ONLY Per accident $ $0 Deductible $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ OEO RETENTION 5 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY X STATUTE ER ANY PROPRIETORIPARTN $0 Deductible ERIEXECUTNE YIN 1,000,000 B OFFICERWEMSEREXCLUDED? NIA Y 9348236-25 11105/2024 11/0512025 E.L.EACH $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 It yes,describe under 1,000.000 DESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT $ Social Service Professional Liability $1,000,00011,000,000 Aggregatell A Improper Sexual Conduct Liability 2024-44927 10/15/2024 10/15/2025 $2,000,00011,000,000 AggregIl lOcc $0 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 1i Additional Remarks Schedule,may be attached if more space is required) City of Santa Ana,officers,agents,employees,and volunteers are included as additionally insured on this policy pursuant to written contract or written agreement per attached endorsement MAC E61.Such insurance as is afforded by this policy shall be primary,and any insurance carried by City shall be excess and noncontributory per attached endorsement NIAC E61. 30 day notice of cancellation with 10 day notice of cancellation for non-payment of premium per policy provision. Waiver of Subrogation applies per attached endorsement MAC E26&10-17 APPROVED By Cynthia Mora at 7:40 an?, Dec 16, 2024 CERTIFICATE HOLDER CANCELLATi SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza Santa Ana CA 92702 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD