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AGENCY CUSTOMER ID: COMMPAR-05 <br />LOC #: <br />ACORO� <br />AIIIIITII(1MA1 REMARKS Srw=n II F <br />AGENCY NAMED INSURED <br />Arthur J. Gallagher & Co. Community Partners <br />1000 N. Alameda St Ste 240 <br />POLICY NUMBER Los Angeles, CA 90012 <br />CARRIER I NAIC CODE <br />EFFECTIVE DATE: <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />Sexual Misconduct Liability is included under: <br />Policy# 2020-18674 : $1,000,000 limit for each claim/$1,000,000 Aggregate <br />Policy# 2020-18674-UMB : Excess $5,000,000 for each claim/$5,000,000 Aggregate <br />Policy: Crime <br />Policy Term: 11 /25/2019 to 5/25/2021 <br />Policy #: UC22378193.19 <br />Carrier: Hiscox Insurance Company Inc. <br />Employee theft: $2,000,000; Deductible: $10,000 <br />ERISA: $2,000,000 <br />Theft of money and securities: $2,000,000; Deductible: $10,000 <br />Money and securities: $2,000,000; Deductible: $10,000 <br />Computer fraud: $2,000,000; Deductible: $10,000 <br />Funds transfer fraud: $2,000,000; Deductible: $10,000 <br />Money orders and counterfeit paper currency: $2,000,000; Deductible: $10,000 <br />Cyber Deception: $100,000; Deductible: $10,000 <br />Paae 1 of 1 <br />RE: Project Name: Media Arts Santa Ana. <br />The City of Santa Ana, its officers, officials, employees, and volunteers are named additional insured with respect to the operations of the named insured. Waiver <br />Df Subrogation on Workers Compensation applies in favor of Additional Insured. The insurance provided in the General liability policy is primary and any other <br />insurance shall be excess only, and not contributing. <br />Written notice shall be provided at least ten (10) days in advance of cancellation for non-payment of premium and thirty (30) days in advance for any other <br />cancellation or policy change. <br />ACORD 101 (2008/01) © 2008 ACORD <br />The ACORD name and logo are registered marks of ACORD <br />HORaN Risk Mwag merdDiAsian <br />REVIEWED & APPROVED BY: <br />o z <br />f R. W&Wd <br />Risk Management Analyst <br />