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Francine 3 Digitally signed by <br />Francine R. Villareal <br />Villareal Date:2021.07.06 11:11:09 <br />-07'00' <br />' DATE <br />CERTIFICATE OF LIABILITY INSURANCE (mMnDonYYv) <br />06170/2021 <br />THIS CERTIFICATE IS ISSUED AS A MAT -MR 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(ies) 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($). <br />PRODUCER <br />CONTACT Certificate Issuance Team <br />NAME. <br />Comprehensive Insurance Services <br />PHONE exr (949) 709-8600 Ealc, No : (949) 709-1669 <br />E-MAIL ADDRESS: mJeremy@thecoprehensiveinsurance.com <br />26429 Rancho Parkway South <br />Suite 120 <br />INSURERtSI AFFORDING COvlr.RAGE <br />AtAIC rf <br />Lake Forest CA 92630 <br />1NSURER A : Nonpsofiis Insuranre Alliance of California <br />10023 <br />INSDRED <br />INSURER B : State Compensation insurance Fund <br />35076 <br />Orange County Fair Housing <br />I%SURFR t; . <br />2021 E. 4th St. Ste. 118 & 122 <br />INSURER D : <br />INSURER E: <br />Santa Ana CA 92705 <br />INSURER F . <br />COVERAGES CERTIFICATE NUMBER- CL2161005236 REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE REEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMC.IT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUZQECTTO ALLTHE TE4tMS, <br />EXCLUSIONS AND CONDITIONS 01- SUCH POLICIES- LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />+UT R <br />LTR <br />TYPE OF INSURANCE <br />INSDADDU <br />WVQ <br />p0l�rCYNLA48ER <br />PO ICY EFF <br />INMiDD1YYYY <br />POLICY <br />MMIDDIYYYY} <br />LIMITS <br />v C0MMFRC4ALG£NERALLIA50.,ITY <br />EACHGCCURRENCE <br />$ 1,000,000 <br />EaCLAIM�MADE PREMIS <br />©ccrreLJ nce <br />$ 5fl0,000 <br />MED EXP (Any one Person) <br />S 20,000 <br />PERSCRAL%ADVINJURY <br />s 1,000,000 <br />A <br />Y <br />2021-03733 <br />0710112021 <br />07)0112022 <br />GEN'L AGGREGATE LIMIT APPLIES PER. <br />GENERALAGGREGATE <br />$ 3,000,000 <br />L <br />POLICY PRET X LOG <br />� ,fEC <br />FRODIICTS - COMPIOP AGG <br />s 3,000,000 <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />C(7A.}6lNEp SfNGLE LIMr T <br />Ea accident <br />S 1,000.000 <br />60DILY INJURY (Per person) <br />s <br />ANY AUTO <br />A <br />QWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />2021-03733 <br />07/0112021 <br />0710112022 <br />9ODILYINJURY (Per accident) <br />S <br />PROPERTY DAMAGE <br />Pee accident <br />NON -OWNED <br />HIRED IX <br />AUTOS ONLY AUTOS ONLY <br />$ <br />X <br />'JVBRELLAL{AB X <br />OCCUR <br />EACH OCCURRENCE <br />3 1,000,000 <br />AGGREGATE <br />$ 1,060,000 <br />A <br />EXCESS LIAB <br />CU IMS MADE <br />2021-03733-UMB <br />0710112021 <br />07/0112022 <br />UED RETENTION $ <br />$ <br />13 <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILJTY YIN <br />ANY PROPRIETORIPARTNER!EXECUTNE N <br />OFPICERIMEMBER EXCLUDECI? <br />(Mandatory in NR) <br />NIA <br />9099740-21 <br />05/16/2021 <br />05/16/2022 <br />X PER STATLSLE ERH <br />E.LF=ACHACCIDENT <br />$ 1,000,000 <br />E.L. DISFASE - EA EMPLOYEE <br />$ 1,000,000 <br />Ir yes, descrbt under <br />DESCRIPTION OF OPERATIONS below <br />E L DISEASE - POLICY LIMIT <br />1,000,fl00 <br />A <br />Imprpper Sexual Conduct Liability <br />2021-03733 <br />07101/2021 <br />0710112022 <br />$1,000,000 Aggregate <br />$1,000,0000cacLrrcenre <br />DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 461, Addrtianai Remarks Sct ed-5e, may Pe attaehed if mare space is required) <br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as Additional In5uled per attached endorsement NIAC <br />E61. This insurance IS Primary and Non-contributory per endorsement NIAG E61. 30 day notice of cancellation with 10 day notice of cancellation for <br />non-payment of premium per policy provision. <br />City of Santa Ana <br />Risk Management Divison <br />20 Civic Center Plaza <br />Santa Ana <br />ACORD 25 (2016103) <br />CA 92701 <br />CANC <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, N077CE WELL SE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />Q 19$8-2015 ACORD <br />The ACORD name and logo are registered marks of ACORD <br />�oRaN RiskManagmentDivisian <br />REVIEWED & APPROVED BY.- <br />o z c <br />of rRdiA.G+L.Z i1. Y1•.♦ 44"d <br />Risk Management Analyst <br />