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Di hall s ned by Francine R.V la real Date: 2022.0 .14 n A� ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDR/Y Villareal Nte:2 2. 02/04/20L1 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(S), 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 Trust Risk Management Services, Inc. doing business in CA as TRMS Insurance Agency 111 Rockville Pike Suite 700 CONTACT NAME: Trust Risk Management Services, Inc. PHONE o, Ext): (855) 655-1801 FAX (A/C, No): (855) 850-2230 EMAIL Rockville, MD 20850 ADDRESS: alliedinfo@trustrms.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: ACE American Insurance Company 22667 INSURED INSURER B: REACH EMPLOYEE ASSISTANCE INC INSURERC: 101 E Lincoln Ave Ste 230 Anaheim, CA92805-3206 INSURERD: INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE 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 ADD SUB POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY G73741361 02/15/2022 02/15/2023 EACH OCCURRENCE $1,000,000 CLAIMS MADE ® OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $150,000 MED EXP (Any one person) $25,000 PERSONAL & ADV INJURY $Included GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $$ POLICY PROJECT LOC PRODUCTS—COMP/OP AGG $$ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per Person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY Y / N PER STATUTE OTH- ER $ E. L.EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under ❑ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below A PROFESSIONAL LIABILITY Occurrence G73741361 02/15/2022 02/15/2023 EACH INCIDENT ANNUAL AGGREGATE $1,000,000 $3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City Santa Ana County/Benefits Dept, officers, agents, employees, and volunteers are named as additional insured on this policy pursuant to written contract, agreement or memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by the City shall be excess and contributory. Certificate of insurance shall provide thirty (30) day prior written notice of cancellation CERTIFICATE HOLDER CANCELLATION City of Santa Ana / Benefits Dept P.O. Box 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS Santa Ana, CA 92702-1988 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPO The ACORD name and logo are registered marks of ACORD µ J_/ F °x s..�... R ILLi3R M&T7A�'t'.Ih12ftLDtVi8l01t R�EWED & APPROVED BY.- Wsk Management Analyst