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AC® CERTIFICATE OF LIABILITY INSURANCE DATE[MMIDDIYYYY)
<br /> li..� 8/12/2025
<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(€es)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 endorserrent(s).
<br /> PRODUCER CONTACT
<br /> CalNonprofits Insurance Services PHONE Samantha Ibarra FAX
<br /> 1500 41 st Avenue, Suite 22$ . 831-824-5022 AIC No:
<br /> Capitola CA 95010 ADDRESS: samantha@cal-insurance.org
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:Nonprofits Insurance Alliance of California 10023
<br /> INSURED AIDSSER-01 INSURER B:Underwriters at Lloyds,London
<br /> AIDS Services Foundation of Orange County, DBA: Radiant Health Centers INSURER c,Republic Indemnity Company of America 22179
<br /> 17982 Sky Park Circle, Ste.J INSURER D:Landmark American Insurance Company 33138
<br /> Irvine CA 92614 INSURER e:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:1806685280 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 /> INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP
<br /> LTR POLICY NUMBER MMIDDIYYYY MMlDDIYYYY LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y 01-CP-0008363-01-1 7/29/2025 7/29/2026 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE M OCCUR DAMAGE RENTED
<br /> PREMISES Ea occurrence $500,000
<br /> MED EXP(Any one person) $20,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000
<br /> rXPOLICY PE0
<br /> PRO 1-1-
<br /> POLICY PRODUCTS-COMP/OP AGG $3,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY Y Y 01-CP-0008363-0'I-1 7/29/2025 7/29/2026 COMBINED SINGLE LIMIT 00,000
<br /> Ea acc $1,0
<br /> ident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED accident Per BODILY INJURY $
<br /> AUTOS ONLY AUTOS ( )
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Par accident $
<br /> $
<br /> A X UMBRELLALIAB X OCCUR 01-UM-0008363-01-15 7/29/2025 7/29/2026 EACH OCCURRENCE $2,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000
<br /> pEb X RETENTION $
<br /> C WORKERS COMPENSATION Y 25773901 1/1/2025 1/1/2026 X PER �RH
<br /> AND EMPLOYERS'LIABILITY YIN
<br /> ANYPROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICERIMEMBEREXCLUDED7 ❑ NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> if yS,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> B Cyber Liability L1957CYLA240 2126/2025 2/26/2026 PollcyAggregate $1,000,000
<br /> D Professional-Mad Mal LHM865080 2/26/2025 2/26/2026 Each Claim/Aggregate $1M1$3M
<br /> A Accident Liability 07-AC-0008363-01-08 7/29/2025 7/29/2026 Llmil $1,00D,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be atlached If more space is required)
<br /> Social Service Professional Liability-Policy Number 01-CP-0008363-01-1 Eff 07/29/2025-07129/2026.Each Claim/Aggregate$1M1$3M
<br /> Improper Sexual Conduct&Physical Abuse Liability-Policy Number 01-CP-0008363-01-1 Eff 07/29/2025-07/2912026.Each Claim/Aggregate$1 MI$3M
<br /> Liquor Liability-Policy Number 01-CP-0008363-01-1 Eff 07/29/2025-07/2912026,Each Event/Aggregate$1M1$1 M
<br /> Commercial Umbrella Policy#01-UM-0008363-01-15 follows form regarding Commercial Package Policy#01-CP-0008363-01-1.
<br /> Project Number:A-2024-089-02.
<br /> City of Santa Ana,officers,agents,employees,and volunteers are included as Additional Insured with respect to General Liability and Business Auto Liability as
<br /> See Attached...
<br /> CERTIFICATE HOLDER ApPROVIED t ANCELLATION
<br /> By Trr Iran Nguyen at 3:09 pm,Aug 20,202 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 uiguallyslgacd ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Community Development Agency Tu Tran Arnan
<br /> 20 Civic Center Plaza, M-25 Nguyen p M.2025.09.20� AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701
<br /> O 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
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