ORANGE COUNTY CHILDREN'S THERAPEUTIC ARTS CENTER (15)

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ACOR& CERTIFICATE OF LIABILITY INSURANCE `i F DATE (MM DDIYYYY) 1 08/27/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the Policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Certificate Issuance Team NAME: Comprehensive Insurance Services 26429 Rancho Parkway South PHONE (949) 709-8800 FAX (949) 709-1668 A/C No Ex[: AIC, No: E"MAIL lerem thecom rehensiveinsurance.com ADDRESS: y� p Suite 120 INSURER(S) AFFORDING COVERAGE NAIC# Lake Forest CA 92630 INSURERA: State Compensation Insurance Fund 35076 INSURED INSURER B : Orange County Children's Therapeutic Arts Center INSURER c: 2215 N. Broadway INSURER D INSURER E : Santa Ana CA 92706 INSURER F: COVERAGES CERTIFICATE NUMBER: WC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR LTR TYPE OF INSURANCE AODL INSD SUOR MO POLICY NUMBER POLICY EFF MMIDD/YYYY P LICYEXP MM/DDNYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -WOE PREMISES Ea occurrence $ MED EXP (Any one Person) $ PERSONAL$ ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: POLICY ❑ PRD ❑ JECT LOC GENERALAGGREGATE $ PRODUCT$ - COMP/OP AGG $ $ OTHER: MOBILELIABILITY COMBINED SINGLE LIMIT Ea accdarlANYAUTOBODILY $ INJURY(Par Person) $ OWNEDSCHEDULED AUTOSONLY AUTOS RAG, BODILY INJURY Per accident ( )HIRED $ NON -OWNED OS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMI DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, tlescdbe under DESCRIPTION OF OPERATIONS below NIA 9255171-2019 O6/05/2019 O6/OS/2020 PER OTH- X STATUTE ER L. E.EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) The City of Santa Ana, its officers, employees, agents, and representatives. 30 day notice of cancellation with 10 day notice of cancellation for non-payment of premium per policy provision. REVIEWE & APPROVED By Risk MA DEMENT Divi$iON City of Santa Ana Risk Mangement Division 20 Civic Center Plaza 4th FI. Santa Ana LAMBERT CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988.201SACORDCORPORATION A116rchfnru —ri ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD