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<br />ACCM CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (M
<br />`✓�
<br />01/12,2021
<br />21'2021
<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 />CONTACT Certificate Issuance Team
<br />Comprehensive Insurance Services
<br />AIONNo Ext: (949) 709-8800 Falc No : (949) 7 99-1668
<br />26429 Rancho Parkway South
<br />E-MAIL jerem Y@Ihecomprehensiveinsumnce.com
<br />ADDRESS: y@ P
<br />Suite 120
<br />INSURERS AFFORDING COVERAGE
<br />NAIC N
<br />Lake Forest CA 92630
<br />INSURERA; Nonprofits Insurance Alliance of California
<br />10023
<br />INSURED
<br />INSURERS: StarNei Insurance Company
<br />40045
<br />Delhi Center
<br />INSURER C :
<br />505 E. Central Ave.
<br />INSURERD:
<br />INSURER E :
<br />Santa Ana CA 92707
<br />INSURERF:
<br />COVERAGES CERTIFICATE NUMBER: CL20iOi9u492u RFVIRIr1N NUMBER:
<br />THIS ISTO CERTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMEDA13OVE FORTHE POLICYPERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAYBE 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 />ITR
<br />TYPE OF INSURANCE
<br />ADDLSUEIR
<br />INSD
<br />Me
<br />POLICYNUMBER
<br />POLICY EXP
<br />MMIDDfYYYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />"l OCCUR
<br />EACH OCCURRENCE
<br />1,000,000
<br />$CLAIMS-MADEI
<br />PREMISES Ea occurrence
<br />$ 50D,000
<br />MED EXP(Any one person)
<br />$ 20,000
<br />FMMIDCNYYY
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />A
<br />Y
<br />2020-01376
<br />11/01/2021
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY 0 JECT ® LOG
<br />GENERALAGGREGATE
<br />$ 3,000,000
<br />PRODUCTS - COMP/OP AGO
<br />$ 3,000,000
<br />OTHER:
<br />$0 Deductible
<br />$
<br />AUTOMOBILE
<br />LIABILITY
<br />COMB I NED SINGLE L IMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY person)
<br />$
<br />ANYAUTO
<br />-
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />2020-01376
<br />11/01/2020
<br />11/01/2021
<br />BODILYINJURY Per accitlent
<br />( )
<br />$
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />X
<br />PROPERTY DAMAGE
<br />Peracpldent
<br />$
<br />$0 Deductible
<br />$
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DEO
<br />RETENTION $
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIASILITY YIN
<br />ANY PROPRIETOR/PARTNERIEXECUTIVE ❑
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatory In NH)
<br />If yes,DESCRIPTION
<br />IPTI Nunder
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />BNUWC0152fi22
<br />11/0112020
<br />11101/2021
<br />PER OTH-
<br />X STATUTE ER
<br />$0 Deductible
<br />E.L. EACHACCIDENT
<br />$ 1.000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />Social Service Professional Liability
<br />Improper Sexual Conduct Liability
<br />2020-01376
<br />11/01/2020
<br />11/01/2021
<br />$3,000,000/500,000
<br />$1,000,000/1,000,000
<br />Aggregate/Occurr.
<br />Aggregate/Occurr,
<br />$0 Deductible
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is read Iran)
<br />City of Santa Ana, officers, agents, employees, and volunteers are named as additionally Insured on this policy pursuant to written contract, agreement, or
<br />memorandum of understanding per attached endorsement CG2026. Such insurance as Is afforded by this policy shall be primary, and any insurance carried
<br />by City shall be excess and noncontributory per attached endorsement NIAC E61. 30 day notice of cancellation with 10 day notice of cancellation for
<br />non-payment of premium per policy provision.
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza
<br />Santa Ana
<br />CA 92702
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />9)1968-2015 ACORD
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />ae RlekManagement Division �
<br />°yl+i s@b REVIEWED&rAPtPLROlVAEDBY: A=` `1'4R4Gi-t=C I�, yTwr.C,nAtpT.
<br />Risk Management Analyst ^_1
<br />
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