COMMUNITY HEALTH INITIATIVE OF ORANGE COUNTY (2)

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Digltally signed by Francine R. Francine R. Villareal Villareal Date. 2021 03 o313sssn-(Alm ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMNJD/YYYY) 02/26/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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 NAME: CONTACT Certificate Issuance Team Comprehensive Insurance Services PHDNE "" 709-8800 FAX (949) 709-1668 A/C No Ext : A/C. No 26429 Rancho Parkway South A.DUliess:jeremy@thecomprehensiveinsurance.com Suite 120 INSURERS) AFFORDING COVERAGE NAIC N Lake Forest CA 92630 INSURERA: Nonprofits Insurance Alliance of California 10023 INSURED INSURER B: Community Health Initiative of Orange County INSURER C: 1505 E. 171h Street, Suite 121 INSURER D: INSURER E : Santa Ana CA 92705 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2082704831 REVISION NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MMIDO/YYVV al P MMIODIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY � OCCUR EACHOCCURRENCE $ 1,000,000 UAWGLIOKENIECLAIMS-MADE cc PREMISES Eaou anca $ 500,000 MED EXP(Any one person) $ 20,000 PERSONAL &ADV INJURY $ 1,000,000 A Y 2020-44927. 10/1512020 10/15/2021 GEN'L AGGREGATE LIMIT APPLI ES PER: POLICY ❑ PRO FX LOG ECT GENERAL -AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2.000,000 OTHER: - $0 Deductible $ LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO AOWNED POMOBILE SCHEDULED AUTOS ONLY AUTOS 2020-44927 10/1512020 10/15/2021 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY PROPERTY DAMAGE Peraccldent $ $0 Deductible $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN PER OTH- STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETOWPARTNEWEXECUTIVE El OFFICER(MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) (ryes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS be. Social Service Professional $1,000,000/1,000,000 Aggregate/Occ A Improper Sexual Conduct 2020-44927 1011512020 1D115/2021 $1,000,000/1,000,000 Aggregate/Occ $0 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is required) City of Santa Ana, officers, agents, employees, and volunteers are Included as additionally Insured on this policy pursuant to written contract or written agreement per attached endorsement NIAC E61. Such Insurance as Is afforded by this policy shall be primary, and any insurance Carried by City shall be excess and noncontributory per attached endorsement NIAC E61. 30 day notice of cancellation with 10 day notice of cancellation for non-payment of premium per policy provision. 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 @ 1988-2015 ACORO ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ysu M &ManagementDivision 8 �#�3 REVIEWED 6 APPROVED BY: aaat�c n a P. v �� RISk ManagerrrerR/VTBlysk