ORANGE COUNTY CONSERVATION CORPS (5)

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o�suany oe-d by aandne It Francine R.Villareal VIII.—i mrc zort.m.is raea:os ueva A� o® CERTIFICATE OF LIABILITY INSURANCE DATE (MMID lY ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Arthur J. Gallagher & Co. Insurance Brokers of CA., Inc. 505 N Brand Blvd, Suite 600 Glendale CA 91203 CONTACT Annie Lee PHONE FAx D Na Eat. 8'8.539.8601 IJC No:818.539.8701 aoliaEss: Annie Lee a' .com INSURE S AFFORDING COVERAGE NAIC If INSURER A: Great American Alliance Insurance Company 26832 License#: 0726293 INSURED ORANC011-19 Orange County Conservation Corps 1853 N. Raymond Ave. INSURER B: Great American Insurance Company Of NY 22136 INSURERC: INSURERD: Anaheim, CA 92801 NSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 802897524 REVISION NUMRPR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MMIDOIYYW POLICY UP MM/DDIYYYY LIMITS A X COMMERCIALGENERAL LIABILITY CLAIMS -MADE � OCCUR Y PAC 515468016 10/1/2020 10/1/2021 EACH OCCURRENCE $1,000,000 DA MIST RENTED PREES Ea occurrexe $100,000 MED UP (Any am person) $ 5,000 PERSONAL &ADV INJURY $1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER:. POLICY ❑JECT LOG GENERAL AGGREGATE $3,000,000 PRODUCTS - COMP/OP AGO $3,000,000 $ OTHER: B AUTOMOSILELIABILITY CAP 099124907 10/1/2020 10/1/2021 COEaMBIaccitlEenfNDSINGLE LIMIT $1,000,000 X ANY AUTO BODI LV INJURY Per person) $ OWNED SCHEOOULEO AUTOS ONLY AUTS ( ) BODILY INJURY Per acgtlent $ HIRED X NIPROPERTY—DAMAGE AUTOS ONLY AUTOS ONLY X Per accident)$ Comp & Collision $ 5004$500 A X UMBRELLALIAB X OCCUR UMB 560379516 10/1/2020 10/1/2021 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESSLIAB CLAIMS -MADE DED X RETENTION$ in nnn $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANYPROPRIETOR/PARTNERIEXECUTIVE ❑ OFFICERIMEMBEREXCLUDED? NIA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ (Mandatory in NH) If yes, describe under EL.DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below A Abuse and molestation PAC 5154680 16 101112021 10/1/2021 Per Claim $1,000,000 Aggregate $3,000.000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Policy: Professional Liability Policylit: PPAC 5154680 16 Carder :Great American Alliance Insurance Company Policy Term: 10/01/2020-10101/2021 Per Claim: $1,000,000 /Aggregate: $3,000,000 The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as named additional insured with respect to the operations of the named insured. Workers Compensation coverage is evidence only. Written notice shall be provided at least ten It 0) days in advance of cancellation for non-payment of premium and thirty (30) days in advance for any other cancellation or policy change. City of Santa Ana Risk Management Division, 20 Civic Center Plaza, 4th floor Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. A'UT11HORIZEDREI UT' 1-\4601 © 1988-2015 ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 41yp1.-AsT" [CREVIEWED & D APPROVED BI q ' rMUhYiNa[ >Q, VilliNSGf4 Risk Management Analyst