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Ace CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
<br /> 11"Ii 10/2712025
<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(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
<br /> Arthur J. Gallagher Risk Management Services, LLC PHONE Chloe Huckaba FAX
<br /> 2050 Main Street E :559-635-3559 Arc No
<br /> Suite 1250 ADOR.ss: Chloe Huckabay@ajg.com
<br /> Irvine CA 92614 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Lioense#:OD69293 INSURER A:Wesco Insurance Company 25011
<br /> INSURED THOMHpi1-a2 INSURER B:Service American Indemnity Company 39152
<br /> Thomas House Temporary Shelter
<br /> PO Box 2737 INSURER C:Security National Insurance Compariv 19879
<br /> Garden Grove CA 92842 INSURERD:Arch Insurance Company 11150
<br /> INSURER E
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:731591517 REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE ENSURED 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 ADDL SUBR POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD ZOa POLICY NUMBER IMMIDDffYYYI (MMIDDIYYYY LIMITS
<br /> C X COMMERCIAL GENERAL LIABILITY Y Y VVPP2087817 10/312025 10/312026 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE O OCCUR DAMAGE TO RENTED
<br /> PREMISES Ea occurrence $100,000
<br /> MED EXP(Any one person) $5,000
<br /> PERSONAL&ADV INJURY $1,000,00o
<br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S3,000,000
<br /> POLICY JECTPRO ❑ LOC PRODUCTS-COMPIOP AGG $3,000,DD0
<br /> X 1:1Ro-
<br /> OTHER: $
<br /> C AUTOMOBILE LIABILITY Y Y SPP1822767 01 10I312025 1013/2026 COMBINED SINGLE LIMIT $1,000,000
<br /> Ea accident
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY $
<br /> AUTOS ONLY AUTOS (Per accident)
<br /> X HIRED X NON-OWNED PROPERTYDAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> $
<br /> A X UMBRELLA LIAR X OCCUR WUM1829118 06 10/312025 1013/2026 EACH OCCURRENCE S 1,00Q000
<br /> EXCESS LIAR CLAIMS-MADE AGGREGATE S 1,000,000
<br /> ❑ED I X RETENTION$ S
<br /> B WORKERS COMPENSATION Y SAT1S0344905 101112025 10/1/2026 X STATUTE EERH
<br /> AND EMPLOYERS'LIABILITY Y 1 N
<br /> ANYPROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICERIMEMBEREXCLUDED? NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OFOPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> C Social SenAces Prof.LiablFSO WPP208781'7 1013/2025 10/3/2025 Each IncidentlAgg $1 M 1$3M
<br /> C Sexual cr Physical Abuse WPP2087817 10/312025 10/3/2026 Each IncidentlAgg $1 M 1$3M
<br /> D Executive Package-See below NFP012112208 11/23/2024 11123/2025
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Executive Package-11/23/2024-1112312025 Policy#NFP012112208
<br /> Director&Officers&Employment Practices Liability: Digitally signed by APPROVED
<br /> Limit of Liability:$1,000,OD0 Deductible$5,000 Tu Tran TuTran Nguyen
<br /> By Tu Tran Nguyen at$:19 am,Nov 04,2025
<br /> Date:
<br /> Fiduciary: Nguyen 08:19:39-08,00,
<br /> Limit of Liability:$250,000 Deductible$0
<br /> City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are included as Additional Insured as respects General Liability and
<br /> Auto Liability policies,pursuant to and subject to the policy's terms,definitions,conditions and exclusions.Waiver of Subrogation applies to(CH/Al entities)as
<br /> See Attached...
<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 /> Attention: Community Development Agency, Homeless
<br /> 20 Civic Center Plaza, M25 AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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