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CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDMYY) <br />9/1/2017 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE <br />CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED THE POLICIES <br />BY <br />BY <br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE <br />AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must he endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder In lieu of such endorsements . <br />PRODUCED <br />CO TACT Certificate I9avaRCO Team .NAME: _ <br />Comprehensive Insurance $Brv1Ce8 'r <br />PHONE (ggg)709-8S00 �— FAX <br />Brno: A[C �)., " 11709-1669 ' <br />26929 Rancho Parkway South <br />E-MAIL info -- - -- <br />ADDRESS: inf O thecompreherTSYveinsurance. corn <br />Suite 120 <br />INSURER(S)AFFORDINGCOVERAGE <br />NAIC4 <br />Lae Forest CA 92630 <br />INSURER A:NOn rofits Ins Alliance of CA '-' <br />11845 <br />— _ <br />✓ <br />America On Track <br />INSURER a: <br />INSURER C: <br />600 W. $8Rt8 Ana Blvd. <br />Ste. 710 <br />INSURER D: T._—._ <br />_.. ..—....—.—_._. <br />INSURER E <br />__....—.___. <br />Santa Ana CA 92701 <br />-- <br />IN pER F: <br />"CV101vIY IYVmt3tH: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED <br />ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT <br />TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />A D SUBR <br />LTR TYPE OF INSURANCE POLICY NUMBER POUCV EFF tPOLICY EXP LIMBS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />A <br />CLAIMS <br />EACH OCCURRENCE <br />$ 1, 000, 000 <br />-"" — <br />DAMI RENTED <br />PREM�E$(Ee occurrence)„ <br />-MADE X OCCUfl <br />$ 500,000 <br />X <br />2017-06180-NPO <br />9/1/2017 <br />9/1/2018 <br />MEO EXP An one preen) r <br />_PAS. _ <br />$ 20,000 <br />PER9GNADV L&AINJURY <br />_ <br />$ 1,OOD,000 <br />- <br />LIMIT APPLIES PER: <br />POLICY ❑ LOC <br />GEWLAGGREGATE <br />GENERALAGGREGATE <br />- --- ----- <br />$ 2,000,000 <br />JEOOT <br />PRODUCTS -COMP/0_P AGO <br />$ 2,000,000 <br />OTHER: <br />1 <br />1 <br />$0 Deductible <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />_(Ea accident)_ <br />$ 1, 000, 000 <br />A <br />ANY AUTO <br />_ <br />BODILY INJURY (Pei person) <br />_ <br />$ <br />ALL OWNED F7 SCHEDULED----- <br />AUTOS AUTOS <br />2017-06180-NPO <br />9/1/2017 <br />9/l/2018 <br />-------- <br />BODILY INJURY Per accident <br />-- --.--- <br />$ <br />X <br />HIREDAUTOS NON -OWNED <br />X AUTOS <br />-_---- <br />PROPERTY DAAMAGE- <br />_(Per accident <br />$0 Deductible <br />$ _— -- <br />UMBRELLALIAR <br />OCCUR <br />_EACH OCCURRENCE <br />$ <br />EXCESS UAB <br />CLAIMS -MADE <br />$ <br />__ <br />AGGREGATE <br />DEC RETENTION A$ <br />WORKERS COMPENSATION <br />PER OTH- <br />ANDEMPLOYERS' LIABWTY Y/N <br />_,. S/,TUTE -. Efi.._ <br />ANY PROPRIETOR/PARTNERIEXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />N/A <br />E.L. EACH ACCIDENT <br />$ <br />_. <br />(Mandatory in <br />NH) <br />If <br />If yOa, describe under <br />and <br />E.L. DISEASE - EA EMPLOYE <br />— <br />$ <br />SE <br />E.L, DIBEASE- POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATI N3 below <br />A <br />Improper Sexual Conduct <br />2017-06180-NPo <br />9/1/2017 <br />9/l/2018 <br />$1,000,000Agg1lB00S00EaCl $0 Deductible <br />A <br />Social Be, Professional <br />2017-06180-NPO <br />9/1/2017 <br />9/l/2018 <br />$2,000,000/1,000,000Ea Ode $0 Deductible <br />DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may beaaeched If more space Is required) <br />Additional Insured status applies automatically per written contract or agreement per attached '- <br />endorsement CG2026. 30 day notice Of Cancellation with 10 day notice of cancellation for non-payment of <br />Premium per policy provision. <br />...-..�.....—.. ___ <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />,non/JEREMY <br />©1988-2014 ACORD CORPORATION. All rinhrR <br />HCVHU za (ZUTv/UT) The ACORD name and logo are registered marks of ACORD <br />INS025 (201a0t) <br />