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.� 10 <br />ACOROm CERTIFICATE OF LIABILITY INSURANCE <br />Dareto9ndnola4/2019 Y) <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: N the certificate holder is an ADDITIONAL INSURED, the policy(Wit) must have ADDITIONAL INSURED provisions or 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 />CCONTACT ONE: Cj7"ta Issuance Team <br />RaNE (949) 709,8800 t. Ne1. (949) 709:1688 <br />Comprehensive Insurance Services <br />ADDRESS: J remy®themmpmhenslvelnsumnce.mm <br />26429 Rancho Parkway South <br />INSUREI AFFORD4 COVERAGE <br />MICA <br />Suite 120 <br />INS RERA: NonprofitalnsuramcsAJIQnceof Calif0r is <br />10023 <br />Lake Forest CA 92630 <br />INSURED <br />INSURERS: <br />_ <br />INSURER C: <br />Community Health Initmbve of Orange County <br />INSURER 0: <br />1505 E. 17th Street, Su@e 121 <br />INSURER E : <br />INwRERF: <br />Santa Ana CA 92705 <br />COVERAGES CERTIFICATE NUMBER: CLI992404256 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 VNTH 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 />LTR <br />TYPE OF INSURANCE <br />IN <br />POLICY NUMBER <br />IMOOIYYYY <br />Y <br />LIMITS <br />EACIAL oENIRAL LUBRJTY / <br />COYY12 <br />EACH OCCURRENCE <br />S 1.000.000 <br />✓ <br />CLAILIS.MADE � OCCUR <br />✓ <br />✓ <br />PR MI .M. <br />5000 <br />MEDEXP aMdnan) <br />S 20.000 <br />A <br />Y <br />2019-44927 <br />10/1512010 <br />lotlttr020 <br />PERSONALAAJWINJURY <br />a 1.D00,000 <br />GENLAGGREGXreUMITAPPLIESPER <br />GENERALAGGREGATE <br />S 2.000,000 <br />PCUCY O JE T ® LCC <br />PRODUCTS-COMPIOPAGG <br />S 2.000.000 <br />$o Deductible <br />f <br />OTHEa <br />AUTOYOdLE W&UTr <br />N E LDI <br />IIIANYAUTO <br />s / DD0.000 <br />BOOILYIWURV(P Pasan) <br />S <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AU1D$ <br />2019A4927 <br />10/15/2019 <br />1Otl 5/2020 <br />800nYIWURY(PM..0 rn <br />S <br />A <br />N <br />s <br />HIRED NOKOANED <br />X AUTOS ONLY AUTOS ONLY <br />SO Owumble <br />a <br />UMBRELLA LAS <br />OCCUR <br />EACHOCCURRENCE <br />S <br />AGGREGATE <br />S <br />EXCESS UAQ3 <br />cuuus-MADE <br />pED I I RETENTION f <br />S <br />YIOr1NERS COMMIATRW <br />ANDEYPLOYERS'WIaWTY YIN <br />H- <br />TATU'E I I CK <br />ANY PROPpIETORNARTNER,D(ECUnVE <br />OFMIERIMEMBER EXCLUDEDT <br />NIA <br />EL EACHACCIDENT <br />S <br />(YMMMArya NH) <br />E L DISEASE EA EMPLOYEE <br />S <br />=yd 0asce.~ <br />OESCRIPTgN OF CPERATp/Saww <br />E L DISEASE POLICY LIMIT <br />S <br />A <br />Social Service Professional <br />Improper Sexual Conduct <br />2019A4927 <br />10/152019 <br />10,15/2020 <br />$1,000.00011.000.000 <br />$1,000,OD011,000,000 <br />Aggreplair0m <br />Aggregate/Om <br />$0 Deductible <br />DESCRIPmOR OF OPERATIONS I LOCATIONS I VEWCUi (ACORD 101. Ad4klnnM RPnark. SeM&Aa, Ina, d zru d a coon sped H npWM7 <br />City of Santa Ana, its officers, ampoyees, agents and volunteers are included as Additional Insured automatically per written contract or agmennav/Pey / <br />attached endorsement CG202S.YY G day notice of cancellation Mmth 10 day, notice of wnceltafion for nonpayment of premium per poky provWon. This ✓ <br />insurance is Primary and Noncontributory per attached endorsement NIAC E61. <br />FWzt# 2020 <br />City of Santa Ana <br />Risk Management Division ✓ NC1fE ACnx jC <br />20 Civic Center Plaza <br />Santa Ana CA 92702 <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 />AUT14OR2ED REPRESENTATIVE <br />01988.2015 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD <br />