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ACI CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM'GD"Y�"'
<br />CT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFOROED BY THE POLICIES DESCRIBED HEREIN IS SALL THE TERMS,
<br />10IM2017
<br />THIS CERTIFICATE IS ISSUED ASA 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
<br />POLICIES
<br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE CONTRACT BETWEEN THE ISSUING INSURER(S),
<br />AUTHORIZES
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an Ab01TIONAL INSURED, the Policy(i09) must have ADDITIONAL INSURED provlsioms or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the pollcy, Cortaln policies may require an endorsement. A statement on
<br />this certificate does not donor rights to the certificate holder In lieu of such andorsemenl(s).
<br />PRODUCER
<br />NAOTA T Certificate Issuance Team
<br />Comprehensive Insurance Services
<br />PHONE(gg9)709800 (9g9)70B•1688
<br />j4c; No 8
<br />28428 Rancho Parkway South
<br />AIC, No ;
<br />D info(PthewmprehensiveinGUTEMCe Com
<br />Suite 120
<br />ESS:
<br />INSURER($) AFFORDING COVERAGE NAIL R
<br />Lake Forest
<br />INSURERA; Nonproflt9loSUfanCe AlllanC80f Cali(omla 11846
<br />CA 92630
<br />INSURED
<br />INSURER R: CompWest Insurance Company 12177
<br />Delhi Center
<br />INSURER C :
<br />RENCE S 1.000,000
<br />505 E. Central Ave.
<br />INSURER D
<br />OCCUR
<br />INSURER E:
<br />Santa Ane CA 82707
<br />INSURERF:
<br />rnveanncR r„�.n�,,.���•.
<br />THIS IB TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A5PRMilSE8
<br />'LIC
<br />E POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACTOR OTHER DOCUMENT
<br />CT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFOROED BY THE POLICIES DESCRIBED HEREIN IS SALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />LTR
<br />TYPE OF INSURANCE
<br />IN
<br />p
<br />POLR:Y NUMBER
<br />MMIOpryYYY
<br />yw–
<br />MMIp�IYYyYLIMITS
<br />X1 COMMERCIAL GENERAL LIABILITY
<br />G4uMS-MAGE F
<br />RENCE S 1.000,000
<br />oceiner R g 6 0,000ore
<br />OCCUR
<br />person g 20,000
<br />PERSOIVl. AW INJURY S 1,000,000
<br />A
<br />Y
<br />2017 -01376 -NPO
<br />11/01/2017
<br />11/01/2018
<br />GENT, AGGREGATE LIMIT APPLIES PER'.
<br />GENERALAGGREGATE g 3,009000
<br />%t POLICY❑JET
<br />PRODUCTS• LCEIPIOP AGG S 3,000,000
<br />LOC
<br />OTHER.
<br />$0 Deductible g
<br />AUTOMOSILELIABIIJTY
<br />GOMDIN SINOL LIMh�
<br />Ea dctiAvnl)__ _. S 1,000,000
<br />ANY AUTO
<br />BODILY INJURY (Par person) 5
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />2017 -01376 -NPO
<br />11/01/2017
<br />11/01/2018
<br />BODILY IWURY(Pera¢lden0 S —�
<br />X
<br />HIRED
<br />AUTOS ONLY x AUTOS ONLY
<br />PROPERTY DAMAGE -
<br />PBr3cG4elll) $
<br />50 Deductible g
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE S
<br />EXCESS LAS
<br />CLAIMS -HYDE
<br />AGGREGATE S
<br />DEC I I RETENTION f
<br />WORKERS COMPENSATION
<br />AND
<br />S
<br />%�
<br />EMPLdVER9'llABllltt YIN
<br />STATUi _FjEaµ
<br />EL S 1,000,000
<br />EACH ACCIDENT
<br />B
<br />ANY PROPRIETOWPARTNERIUECUTIVE ❑
<br />OFFICERIMEMSER EXOWOEOp
<br />NIA
<br />WCV540042002
<br />71!01/2017
<br />1110112018
<br />a DISEASE - EA EMPLOYEE S 1,000,000
<br />IMinnin.ry In NHl
<br />yet Uescrtbv oder
<br />EL DISEASE POLICY LIMIT S 1.000,000
<br />DESCRIPTION OF OPERATIONS below
<br />Social Service Professional Liability
<br />$3,000,000/1,000,000 A99-0t-/QCC-n
<br />A
<br />Improper Sexual Conduct Liability
<br />201701375 -NPO
<br />11/01/2017
<br />11/01/2018
<br />$1,000,000/1,00D,000 Aggregate/Occur.
<br />$0 Deductible
<br />DESCRIPTION OF OPi"nONS r LOCATONS I VE111CLE6 IApORD 1 Ut, Adtlilivnal RvmaM1s BVMGila, may Lv ptlacbatl Ir mpry spew Is roqulretl)
<br />The Cny of Santa Ana its officers, employees. agents and volunteers are included as Additional Insured automatically per written contract
<br />or agreement per attached enoor emenl CG2026. 30 day Notice of Cancellation wih 10 day round of cancellation for non-payment or premium �I
<br />per policy provision. This Insurance is Primary and Non -Contributory per attached Endorsement NIAC E61. h ,. p -VVI
<br />L�7� �
<br />Jk�\TSO✓}aril
<br />! '�7
<br />CERTIFICATE HOLDER IAurer I nTlnu
<br />01988.2015 ACORD CORPORATION, All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<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
<br />ACCORDANCE WITH ME POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />_
<br />AUTHORIZED REPRESCNTATIVE
<br />Santa Ana CA 92702,
<br />y
<br />01988.2015 ACORD CORPORATION, All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
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