|
DATE(MM/DD/YYYY)
<br /> ,a► �ra` CERTIFICATE OF LIABILITY INSURANCE
<br /> 06/17/2026
<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 Department
<br /> Newfront Insurance Services, LLC A/CON No,
<br /> Ext: (415)754-3635 FAX No):
<br /> 777 Mariners Island Blvd E-MAIL ADDRESS: certs@newfront.com
<br /> Suite 250 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> San Mateo CA 94404 INSURERA: Alliance of Nonprofits for Insurance,Risk Retention Group,Inc. 10023
<br /> INSURED INSURERB: State Compensation Insurance Fund 35076
<br /> Asian American Senior Citizens Service Center Inc(AASCSC) INSURERC: Underwriters at Lloyds,London
<br /> INSURER D
<br /> 850 North Birch Street INSURER E
<br /> Santa Ana CA 92701 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 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 SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD POLICY NUMBER MM/DD MM/DD
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> DAM
<br /> CLAIMS-MADE � OCCUR PREM SESOEa occurrDence $ 500,000
<br /> MED EXP(Any one person) $ 20,000
<br /> A X X 01-CP-0001391-01-03 06/05/2026 06/05/2027 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 3,000,000
<br /> X POLICY D PRO �
<br /> JECT LOC PRODUCTS-COMP/OPAGG $ 3,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea accident
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> A OWNED SCHEDULED X X 01-CP-0001391-01-03 06/05/2026 06/05/2027 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTYDAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> rx $
<br /> HB OCCUR EACH OCCURRENCE $
<br /> $CLAIMS-MADE AGGREGATE $
<br /> TENTION$ $
<br /> WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y STATUTE ER
<br /> B OFFICER/MEMBER EXCLU EXCLUDED?
<br /> ❑ N/A X 9100741-2025 10/01/2025 10/01/2026 E.L EACH ACCIDENT $ 1,000,000
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> Limit $1,000,000
<br /> C Cyber Liability ES00340533880 10/01/2025 10/01/2026 Deductible $2,500
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> (Insurer A)-Sexual Misconduct, Physical Abuse,and Molestation Liability-01-CP-0001391-01-03-(06/05/2026-06/05/2027)-Each Occurrence:$1,000,000,
<br /> Aggregate:$1,000,000
<br /> (Insurer A)-Professional Liability-01-CP-0001391-01-03-(06/05/2026-06/05/2027)-Each Occurrence:$1,000,000,Aggregate:$3,000,000
<br /> City of Santa Ana, its City Council, its officers,officials,employees,agents,and volunteers are included as an additional insured as required by a written
<br /> contract with respect to General Liability and Auto Liability.Waiver of subrogation applies with respect to General Liability,Auto Liability and Workers
<br /> Compensation policies as required by written contract.
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 10:29 am,Jun 18,2026
<br /> 4
<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 /> Attn: Library Services, Dylan Dario
<br /> AUTHORIZ ESENTATIVE
<br /> 20 Civic Center Plaza, M-42
<br /> Santa Ana CA 92701
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
|