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Tori Pierson °rosigned " aa,2-0,ron.
<br />TRAIAND-01 DOLDENBERG
<br />A4CORL7CERTIFICATE OF LIABILITY INSURANCE
<br />�-�
<br />DAT110120IY
<br />snotzo1
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<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 pollcy(les) 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 License # L700460
<br />CRRWACr
<br />Knauf Maxwell Insurance Services
<br />2900 W. Broadwayy
<br />Los Angeles, CA 90041
<br />PHONE FAX
<br />INC, No, Ex4: (323) 550-7900 INC. No):(323) 256-0800
<br />ApDFeS, knaufreception@kmins.com
<br />INSURE S AFFORDING COVERAGE
<br />NAICe
<br />INSURERA: Nonprofits Insurance Alliance of California, Inc.0
<br />INSURED
<br />INSURERB:State Compensation Insurance Fund
<br />INSURERC:
<br />Training and Research Foundation
<br />1442 E. Lincoln Ave., Ste 371
<br />Orange, CA 92865
<br />INSURERS:
<br />INSURER E:
<br />INSURERF:
<br />COVERAGES CERTIFICATE NUMBER- wcvlclnN milmmco•
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY RECUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />rypE OF
<br />DL
<br />INSD
<br />UM
<br />YWD
<br />POLICY NUMBER
<br />POLICYEFF
<br />IMMIDDAYM
<br />POLICY EXP
<br />[MMfODTYYYY)LIM"
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE [fl OCCUR
<br />X
<br />X
<br />021-52013
<br />7/112021
<br />7h 12022
<br />EACH OCCURRENCE
<br />1,000,000
<br />DAMAGE
<br />REM SET EB RENTEDoccurrce
<br />$ 500,000
<br />MED EXP none rion)
<br />; 20,000
<br />PERSONAL BADV INJURY
<br />1,000,000
<br />GENL
<br />AGGREGATE LIMITAPPLIES PER:
<br />POLICY LOC
<br />GENERAL AGGREGATE
<br />$ 3,000,000
<br />PRODUCTS-COMP/OP AGG
<br />$ 3,000,000
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />OMeBBIINdEeDISINGLE LIMIT
<br />(EeANVAUTO
<br />$ 1000000
<br />BODILY INJURY(Pef parson)$
<br />OWNED SCHEDULED
<br />ONLY
<br />021-52013
<br />7/1/2021
<br />7/1/2022
<br />BODILY INJURY Per accident
<br />X
<br />�SCCHHEDULyED
<br />I�AUTOSOW�pN��E
<br />N1T05 ONLY X AUT°SONLY
<br />PAOPEERJY MAGE
<br />$
<br />A
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />4,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />021-52013-UMB
<br />7/112021
<br />7112022
<br />AGGREGATE
<br />$ 4,000,000
<br />_1jDtX
<br />RETENTION$ O
<br />B
<br />ADREEPLYRSELLT
<br />AFFIFIR RIETORfPARTNER/EXECUTIVE IN
<br />(M es. dee be and
<br />(Me. R' .IBER EXCLUDED?If
<br />Dyes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />MIA
<br />300505-21
<br />7/1/2021
<br />7/12022
<br />TNMOEIABIII• SAT TERH
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />E.L. DISEASE -EA EMPLOYEE
<br />$ 1,000,006
<br />E.L. DISEASE -POLICY LIMB
<br />1,000,000
<br />A
<br />Sexual Abuse
<br />021.52013
<br />7/112021
<br />7112022
<br />Each Occurrence
<br />1,000,000
<br />A
<br />Sexual Abuse
<br />021.52013
<br />7/112021
<br />71IM22
<br />Aggregate
<br />3,000,000
<br />DESCMPnONOFOPERATIONSILOCATIONSIVEHCLES (ACORD 101, Additional Remarks Schedule, maybe atlached Unions apace is required)
<br />Coverage: Improper Sexual Conduct and Physical Abuse Liability
<br />Policy# 202152013
<br />Effective 7/01/2021 to 7/01/2022
<br />$1,000,000 Each Occurrence (Claim) limit
<br />$3,000,000 Aggregagate limit
<br />SEE ATTACHED ACORD 101
<br />City of Santa Ana
<br />Risk Management Divislon
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />ACORD 25 (2016103)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF,
<br />NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROM""'•'
<br />Ni Moagannt DiWsim
<br />AUTHORIZED REPRESENTATIVE
<br />REVIEWED $, AM Bv:
<br />,ueemnr Utnral Aitle
<br />OO 1988-2015 ACORD CC
<br />The ACORD name and logo are registered marks of ACORD
<br />
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