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A� l CERTIFICATE OF LIABILITY INSURANCE
<br />DAr10/3/2018 )
<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 of 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
<br />Arthur J. Gallagher & Co.
<br />Insurance Brokers of CA. LIC. # 0726293
<br />505 N Brand Blvd, Suite 600
<br />Glendale CA 91203
<br />CONTACT
<br />NAME: Janis Lee
<br />gHCNE .818.539.8615 ac No :818.539.8715
<br />nooaiess: 'anis lee@ajg.com
<br />INSURERS AFFORDING COVERAGE NAIC#
<br />INSURER A: Nonprofits' Insurance Alliance of CA
<br />INSURED COMMPAR-05
<br />Community PartnersINSURERS:
<br />New York Marine And General Insurance Company 16608
<br />11/25/2018
<br />1000 N. Alameda St Ste 240
<br />INSURER C:
<br />INSURER D:
<br />Los Angeles, CA 90012
<br />INSURER E,
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: 2102712618 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 />ILTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />POLICYNUMBER
<br />POLICY EFF
<br />MMIDDIYYYY
<br />POLICY EXP
<br />MM/DDIYYYY
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE I OCCUR
<br />Y
<br />201710674 -NPO
<br />11/25/2017
<br />11/25/2018
<br />EACH OCCURRENCE $1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Eaoccurrence) 5500,000
<br />MED EXP (Any one person) $20,000
<br />PERSONAL &ADV INJURY $1,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER:
<br />X POLICY PRO-
<br />JECT LOC
<br />GENERAL AGGREGATE $2,000,000
<br />PRODUCTS-COMP/OPAGG $2,000,000
<br />Liquor Llability $1,000,000
<br />OTHER:
<br />I
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />201718674 -NPO
<br />11/25/2017
<br />11/252018
<br />COMBIN ED S I NGLE LI -MIT $1,000,000
<br />Es accident
<br />X
<br />ANY AUTO
<br />BODILY INJURY (Per person) $
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY Per accident $
<br />( )
<br />X
<br />HIREDX NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE $
<br />Per accitlent
<br />A
<br />X
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />201718674UMBNPO
<br />11/25/2017
<br />11/25/2018
<br />EACH OCCURRENCE $10,000,000
<br />AGGREGATE $10,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I X I RETENTION$ 10 Cop
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />ANDEMPLOYERS'LIABILITY Y/N
<br />ANVPROPRIETOR/PARTNER/EXECUTIVE =
<br />BER EXCLUDED?
<br />OFFICERM(Mandate,
<br />N/A
<br />WC201800007209
<br />10/12018
<br />10/12019
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT $1,000,000
<br />E.L. DISEASE -EA EMPLOYEE $1,000,000
<br />(Mandatory in NH)
<br />in
<br />If yes, describe under
<br />EL.DISEASE- POLICY LIMIT $1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />A
<br />Profeselonal Liability
<br />201718674 -NPO
<br />11/25/2011
<br />11/252018
<br />Each Claim $1,000,000
<br />Aggregate $2,000,000
<br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD rat, Additional Remarks Schedule, maybe attached if more space is required)
<br />Sexual Misconduct Liability is included under:
<br />Policy # 201718674 -NPO : $1,000,000 limit for each claim/$1,000,000 Aggregate
<br />Policy # 201718674UMBNPO : Excess $10,000,000 for each claim/$10,000,000 Aggregate
<br />RE: Media Arts Santa Ana (MASA) a project of Community Partners
<br />The City of Santa Ana, it's officers, employees, agents and representative are named as additional insured. Workers Compensation coverage is Evidence only.
<br />See Attached...
<br />CERTIFICATE HOLDER CANCELLATION
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />IfAJ 1 eL 66 uY CXO-M el(
<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 />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana CA 92701
<br />AUTHORIZED REP ESENTATIVE
<br />i"VFJ0.y�,.
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />IfAJ 1 eL 66 uY CXO-M el(
<br />
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