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ACIQR[- CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (hIMIDD,YYYYI
<br />09(2572018
<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 Pobcy(les) must have ADDITIONAL INSURED provisions or be endorsed.
<br />It SUBROGATION IS WAIVED, subject to the terms and conditions of the Polley, 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 />NAME, DlAnlla Maf1la
<br />Ali-605
<br />PHONE 1, (916)7049070 �a Nnt (91S)78A-U15R
<br />Vernonal StreAgency
<br />805 VrOn Street
<br />ADDaSEE: diarimsoialicalinsurance.com
<br />INSURERS AFFORDING COVERAGE
<br />NAICN
<br />Roseville CA 95678
<br />INSURERA: Nonprofits' Insulance Alliance Of California
<br />011845
<br />NSURED
<br />INSURER : Stela Compensation lDSUrantrl Fund
<br />35076
<br />The LDS Angeles Dream Shapers
<br />P.0 Box3831
<br />INSURER C
<br />—
<br />INSURER D:
<br />INSURER 9:
<br />Orange CA 92865
<br />INSURERF:
<br />R IV VIO
<br />THIS IS TO CC-RTIFY THAT THE POLICIES OF INSURANCE LISTED BELOWHAVE BEEN ISSUED 70 THE INSURED NAMED
<br />ABOVE FOOP
<br />R THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR O'THERDOCUMENT 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 OP SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILTR
<br />TYPEOFINSURANCE —ADO
<br />INSD
<br />SI
<br />VIVID
<br />POLICY NUMBER
<br />LI
<br />MMIDDIYYVV
<br />MMMOrfYYY
<br />LIMITS__
<br />x
<br />COMMERCIAL GENERAL LIABILITY
<br />CWIMS•MAOE ® OCCUR
<br />EACH OCCURRENCE
<br />S 1,000,000
<br />f
<br />$00,000
<br />X
<br />Liquorllability
<br />PREMISE' Eaommm�ce>
<br />S
<br />MEDEXP n onepe,som
<br />3 20,000
<br />A
<br />Y
<br />2018-08000NPO
<br />OW13/2018
<br />W/13(2010
<br />$1,000,000/1,000,000
<br />PERSONAL&AOV INJURY
<br />S 1.000.000
<br />AGGREGATE LIMIT APPLIES PER
<br />POLICY ❑jet,{
<br />GENERALACOREQATE
<br />$ 2,000,000
<br />GENT.
<br />N+
<br />PROOUCi9-GP41ploP AGO
<br />S 2.000,000
<br />LGC
<br />OTHER.
<br />S
<br />AUTOMOBILE
<br />LIADIUTY
<br />COhI IN -0 SINGLE LIMIT
<br />3 1,000,000
<br />O
<br />Ea epeaenp
<br />BODILY INJURY (Per per,")
<br />S
<br />A
<br />2018-08609NPO
<br />08/13/2010
<br />06IM2019ONLY
<br />ONLY !YComp/Colt
<br />LD
<br />JUMOREL;LAUAB
<br />deductible
<br />S 500
<br />EACHOCCURReNCE
<br />S
<br />-MADE
<br />AGGREGATE
<br />S
<br />ETENTION S
<br />S �—
<br />WORKERS COMPNSATION
<br />ANDE6PLOVER3LIABILTY
<br />SRH-
<br />YfN
<br />EL. EACFf (u:C10EPIT
<br />3 1,000,000
<br />B
<br />ANY
<br />MPARTHEMX
<br />OFFICER)`EMBPR EXCLUDED? ECUTIVE ❑
<br />NIA
<br />9010327-18
<br />O6A16J2018
<br />06V06/2U79
<br />E.L. DISEASE -EA EMPLOYEE
<br />3 1,000,000
<br />(Afnaaalary In NH)
<br />IP))es,RIPTIOa antler
<br />EL. DISEASE - POLICY LIMIT
<br />S t,000,000
<br />UESCWPTIpDI OF OPERATIONS CaIrnv
<br />DESCRIPTION OF OPERATIONS( LOCATIONS I VEHICLES IACLTRO 101,Addiftoal Reloatks Se6edule, nmy be aliacUea lTmore spa�eM Rgviretli
<br />`(�`1y
<br />The City of Santa Ana, Its officers, agents, Employees and Volunteers a(a named additional insured under their contract terms. Cover,Rge is at$r And
<br />norI'COnmbutorp and Form CG 20 26 applies
<br />A
<br />�- Y
<br />a
<br />"—••••• •••••••, •••••••", UANUt LLATIUN •((�}}jr`Yv^��TL [•
<br />SHOULD ANY OF THEABOVE ESCRIBELj�iILYCIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS,
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92701 1" �yy{{rr
<br />l�.y TV ^r Vet
<br />®198U-2016 ACORD CO PO RATION. Aff7killis, reserved,
<br />nv�rvun ca 14V InIVJ} I no ACURO name slid logo are registered marks ofACORD
<br />
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