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Digitally signed by Francine R. <br />Francine R. Villareal Villareal <br />Date: 2021-04-19 11.57.35-07'00' <br />ACOR" CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MM/DDmYY) <br />4/9/2021 <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 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 />Arthur J. Gallagher & Co. <br />Insurance Brokers of CA., Inc. <br />N Brand Blvd, Suite 600 <br />CONTACT <br />NAME: Natalia Dlonela <br />PHONE FAX <br />A/C No Ext: 818.539.8633 A/c,No: <br />E-M505 <br />ADDRESS: Natalia_Dionela@AJG.com <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />Glendale CA 91203 <br />INSURERA: Church Mutual Insurance Company <br />18767 <br />License#:0726293 <br />INSURED COMMPAR-05 <br />Community Partners <br />1000 N. Alameda St Ste 240 <br />INSURER B: Alliance of Nonprofits for Insurance Grp <br />10023 <br />INSURERC: <br />INSURERD: <br />Los Angeles, CA 90012 <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 1849657134 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 />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />WVD <br />POLICYNUMBER <br />POLICY EFF <br />MM/DD <br />POLICY EXP <br />MM/DD <br />LIMITS <br />B <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />2020-18674 <br />11/25/2020 <br />11/25/2021 <br />EACH OCCURRENCE <br />$1,000,000 <br />CLAIMS -MADE OCCUR <br />PREMISES DAMAGE TO <br />PREMISES Ea occurrence) <br />ccurrence <br />$ 500,000 <br />MED EXP (Any one person) <br />$ 20,000 <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />POLICY PRO ❑ LOC <br />El JECT <br />X <br />PRODUCTS - COMP/OP AGG <br />$ 2,000,000 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />2020-18674 <br />11/25/2020 <br />11/25/2021 <br />COEaMBINED ident SINGLE LIMIT <br />.cc <br />$ 1,000,000 <br />X <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />X <br />PROPERTYDAMAGE <br />Per accident <br />$ <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />Comp & Collision <br />$ 1,000/$1,000 <br />B <br />X <br />UMBRELLALIAB <br />X <br />OCCUR <br />2020-18674-UMB <br />11/25/2020 <br />11/25/2021 <br />EACH OCCURRENCE <br />$ 10,000,000 <br />AGGREGATE <br />$ 10,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION $ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />ANYPROPRIETOR/PARTNER/EXECUTIVE <br />Y <br />035795207-157136 <br />10/1/2020 <br />10/1/2021 <br />X PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />OFFICER/MEMBER EXCLUDED? ❑ <br />N/A <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />B <br />ProfessionalLiability <br />2020-18674 <br />11/25/2020 <br />11/25/2021 <br />Per Claim <br />$1,000,000 <br />Aggregate <br />$2,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) <br />Policy: Liquor Liability <br />Policy Term: 11/25/2020 to 11/25/2021 <br />Policy #: 2020-18674 <br />Carrier: Alliance of Nonprofits for Insurance Grp <br />Each Claim: $1,000,000 ,Aggregate: $1,000,000 <br />See Attached... <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, <br />NOTICE WILL <br />BE DELIVERED IN <br />City of Santa Ana <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Division <br />20 Civic Center Plaza, 4th floor <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92702 <br />oRa <br />RiskMmRgemerdDMsiun <br />REVIEWED & APPROVED BY: <br />© 1988-2015 ACORD CltC+�e <br />z <br />JZ, (JAWAI <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />' <br />Risk Management Analyst <br />