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1C7 R, CERTIFICATE OF LIABILITY INSURANCE '' Acctp: 2402345 OATENYYY) 4/14/2014/2021 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(les) 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 Lockton Companies, LLC 3657 Brlarpark Dr., Suite 700 CONTACT 888-828-8365 NAME:PHONE FAX Alc No Ao BAL ass, Houston, TX 77042 —INSURER(S) AFFORDING COVERAGE NAICty - INSURER A: Ace American Insurance Co. 22667 INSURED ORANGE COUNTY'S UNITED WAY INSURER B: INSURER C : ORANGE COUNTY UNITED WAY 18012 MITCHELL S - - IRVINE, CA 92614-6008 INSURER D : INSURER E: - - - INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMRER- 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 ADDLSUBR INISID me POLICY NUMBER POLICYEFF IMMIDD/YYYYI POLICYEXP MMIODIYYVY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES IF. occurrence $ MED EXP(Any one person) $ PERSONAL$ ADV INJURY $ AGGREGATE LIMIT APPLIES PER: POLICY JECOT Y LOC GENERAL AGGREGATE $ GEN'L PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea eoul l $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident) ( ) $ HIREDAUTOS AUOOSWNED PROPERTY MAGE Par addldant $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ Ld AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN AY PROPRIETOWARTNEWEXOFFICER/MEMBEER EXCLUDED? ECUTIVE ❑ NIA X C68751949 10/1/2020 10/1/2021 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE —EA EMPLOYEE $ 1,000,000 (Mandatory In NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Notice to Others Endorsement Included RE:Agreement number A-2021-021.04 WAIVER OF SUBROGATION IN FAVOR OF City of Santa Ana WHEN REQUIRED BY WRITTEN CONTRACT. HEAP Subcontractor Agreement with Orange County United Way for Landlord Incentive Program for Foster Youth to Independence Housing Voucher Holders CERTIFICATE HOLDER CANCELLATION CITY OF SANTA ANA RISK MANAGEMENT DIVISION 20 CIVIC CENTER PLAZA SANTA ANA. CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Risk Management Analyst