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ROMAN-5 <br />Aa�ORen CERTIFICATE OF LIABILITY INSURANCE DAOAI9SI1MninnTEIMMIYI <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 pollcy(les) 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 />PRODUCER <br />AI <br />BrekkeSchafnitzlns.0rokers <br />Llcense#OK07568 <br />,.NAM L— <br />PHDNE -.--- <br />uc, Nn, Eat: 949.365-5104 <br />�F—Ax --_--- - -- -- <br />Iplc.Ner949-313-3255 <br />28202 Cabot Road, Suite 600 <br />E-MAIL <br />_ - - <br />Laguna Niguel, CA 92677.1251 <br />.AGnaess <br />_ _ — _ __ <br />_ __ INSURERI6I AFFORDING <br />COVERAGE_ N 190 <br />INSURER A: GuideOne Mutual <br />_— <br />INSURED Catholic Charties of Orange <br />INSURERS; <br />County <br />-�—T- <br />1820 E 16th Street <br />INSURER c <br />Santa Ana, CA 92701 <br />INSURER <br />INSURERE. <br />INSURERF <br />Prl\/FnAGFC CCOTICICATF MIIMGFO• <br />OC\/ICIl1M MIIMCCO. <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 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 OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR TYPE OF INSURANCE <br />ADDL <br />INSO <br />BUB POLICY NUMBER <br />POUCYEFF <br />wonD7 <br />POLICY UP LIMAS <br />COMMERCIALGENERA.IJABaJTY <br />EACH OCCURRENCE It <br />CLAIMS -MADE OCCUR <br />_ <br />j DAMAGE TO RENTED <br />�PREMMULEBnrsu®Alx) <br />MED-EXP My 0n$pere0n <br />PERSONALS ADV INJURY _,p <br />. GEN'L AGGREGATE LIMIT APPLIES PER <br />GENERAL AGGREGATE 4 <br />_ POLICY � j _ LOG <br />PRODUCTS COMP/OP AGO S _ <br />AUTOMOBILEMY <br />.COMBINED <br />ANY AUTO <br />AUTO <br />BODILYp¢—�SINGLE <br />BODILY INJURY (PerPermn <br />S <br />. SCHEDULED <br />AUTOS ONLY ' AUTµOpS <br />I <br />BOOtLY INJ Y e-LIMIT 11 <br />Ep <br />.�I AU OS ONLY AUTOS ONLY <br />(Pe�amEentQAMPGE <br />UMBRELLA LAB __ <br />OCCUR <br />'EACH OCCURRENCE S .-....-.-. <br />EXCESS LAB J <br />CLAIMSMAOE <br />AGGREGATE <br />DED RETENTIONS <br />A WORKERS COMPENSATION <br />;Or <br />X PER OTB- <br />-AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOWPARTNERIEXECUTNE <br />Y 10005295 <br />07f01i2020 <br />D7/0112021 E.L.ACH ACC E 1,000,o00 <br />S <br />OFFICENAIE M q EXCLUDED? <br />NIAIP <br />I NI_ <br />(MXndalRry m NI) <br />;.E1. OI$EASE.-EA EMPLOYE 1,000,000 <br />_—�L <br />Il yee, dOeabP under <br />_. _ <br />1.000,000 <br />DESCRIPTION F E T b I w <br />E POLICY LIMIT S <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 101. Addltkeial RemarMe Shcedele. may be elWi,f e f if more epate b reyPlnd) <br />Waiver of subrogation WC0403060484 Is extended on behalf of City of Santa <br />Ana, its officers, employees, agents and representatives <br />REVIEWED & APPROVED <br />JU21 <br />�° r l <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City Of Santa Ana <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Div 'a <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />ANL <br />(l Vi�LAIZEAL <br />AUTHORIZED REPRESENTATNE <br />ACORD 25 (2016103) 01988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />