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Digitally signed by Tor! Pierson <br />Tori Pierson Date: 2022.01.26122907-08'00' <br />KDEDU-1 OP ID: 01 <br />'`'k� ' CERTIFICATE OF LIABILITY INSURANCE <br />�..•--''' <br />TE Y) <br />70112412022 <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 policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Huntington Pacific Ins. Agency <br />7901 Professional Circle g y <br />CONTACT Mark Heberden <br />NAME: <br />AIC, No, Ext :714-841-6283 FAX No): 714-842-2538 <br />Huntington Beach, CA 92648 <br />Mark Heberden <br />E-MAIL <br />ADDRESS: mark@huntpacificinsurance.com <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURERA :Great American Ins. Company <br />22136 <br />INSURED KID Education, LLC <br />INSURERB:Employers Preferred Ins. Co. <br />10346 <br />dba: Health Staff Training <br />Institute <br />INSURERC : <br />INSURERD: <br />601 S. Milliken Avenue, Ste <br />Ontario, CA 91761 <br />INSURERE : <br />INSURERF: <br />COVERAGES CERTIFICATE NUMBER: 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 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 <br />LTR <br />7ypE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDIYYYY <br />POLICY EXP <br />MM1DDIYYYY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />X <br />PAC 4614028-07 <br />02/02/2022 <br />02/02/2023 <br />DAMAGE TO RENTED <br />PREMISES (Ee occurrence) <br />$ 100,000 <br />CLAIMS -MADE. � OCCUR <br />MED EXP (Any one person) <br />$ 5,000 <br />PERSONAL & ADV INJURY <br />$ 1,000,00 <br />X Professional <br />GENERAL AGGREGATE <br />$ 2,000,00 <br />GEN'L AGGREGATE LIMIT APPLIES PEP <br />PRODUCTS - COMP/OP AGG <br />$ 2,000,00 <br />X POLICY PECROT F7 LOC <br />J <br />Deduct <br />$ 0 <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />(Ee accident) <br />$ <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per. accident] <br />$ <br />NON-ONED <br />HIRED AUTOS WAUTOS <br />F <br />PROPERTY DAMAGE <br />(PER ACCIDENT) <br />$ <br />$ <br />X <br />UMBRELLA.LIAB. <br />X <br />OCCUR. <br />EACH OCCURRENCE <br />$ 2,000,00 <br />AGGREGATE <br />$ 2,000,00 <br />A <br />EXCESS LIAR <br />CLAIMS -MADE. <br />UMB3962500 01 <br />02/02/2022 <br />02/02/2023 <br />DED RETENTION $ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPPIETORiPARTNER1EXECUTiVE Y 1 N <br />EIG2'19667207 <br />02/02/2022 <br />02/02/2023 <br />OT <br />X !NCSTATU- H- <br />TORY LIMITS ER <br />E L EACH ACCIDENT <br />$ 1,000,00 <br />OFFICERfMEMBEREXCLUDED? <br />(Mandatory in NH) <br />NIA <br />E L DISEASE - EA EMPLOYEE <br />$ 1,000,00 <br />fyes, .describe under <br />DESCRIPTION OF OPERATIONS below <br />EL.DISEASE -POLICY LIMIT <br />$ 1,000,00 <br />A <br />AbuselMolestation <br />PAC 4614028-07 <br />02/02/2022 <br />02/02/2023 <br />300,000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101,. Additional Remarks Schedule, if more space is required) <br />City of Santa Ana, its officers, employees, agents and representatives are <br />included as additional insured with respects to the general liability, per <br />attached endorsement as required by written contract. This insurance is <br />primary & Non-contributory. <br />CERTIFICATE HOLDER CANCELLATION <br />CITYSAA <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Drive <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 />AUTHORIZED REPRESENTATIVE <br />RE%Ae&m & APPRavED H . <br />© 1988-2010 ACORD CO _... _... _._ ._... __._ <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />