CHARITABLE VENTURES OF ORANGE COUNTY, INC. (2)

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A� " CERTIFICATE OF LIABILITY INSUAngie DlgltdiiySgn tE(M4/2D/YYYY) b Angie 07/14/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO GHTS UPON - IF, Td@CATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER C6VE1RDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSU '2'RER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 2022.08.1 1 IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have QDITIONP.L. INSU11020i! W7s-&rW r 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 CONTACT Nora Wolkoff NAME: AI.. . Ext : FAX A/C No): Dickerson Insurance Services an Alera Group Company 1918 Riverside Drive, Los Angeles, CA 90039 ADMDRRESS: Nora@dickerson-group.com INSURERS AFFORDING COVERAGE NAIC # License #OM29112 INSURER A: Philadelphia Indemnity Insurance Company 18058 INSURED INSURER B : SERVICE AMERICAN INDEMNITY COMPANY 39152 INSURERC: Charitable Ventures of Orange County INSURER D : 1505 E. 17th Street, Suite 101 INSURER E : Santa Ana, CA 92705 INSURER F : COVERAGES CERTIFICATE NUMBER: 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 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. INSR LTR TYPE OF INSURANCE INM SUPOLICY D POLICY NUMBER EFF MM DD/YYYY POLICY EXP MM DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE IX OCCUR DAMAGEORENTED PREMISESSEa occurrence $ 100,000 MED EXP (Any one person) $ 5,000 Abuse & Molestation (A&M) X Professional Liability (Prof. Liab) PERSONAL & ADV INJURY $ 1,000,000 A Y PHPK2419226 07/01/2022 07/01/2023 GEN1 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ PRO ❑ LOC JECT PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y PHPK2419226 07/01/2022 07/01/2023 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 A EXCESS LIAB CLAIMS -MADE Y PHUB816379 07/01/2022 07/01/2023 DED 1XI RETENTION$ 10,000 A&M and Prof. Liab. $ Included B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? ❑Y (Mandatory in NH) N / A Y SATIS0511000 07/01/2022 07/01/2023 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1 ,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Clerk of the City Council City of Santa Ana is recognized as an additional insured with respect to the operations for the name insured subject to policy terms and conditions. Evidence only as respects to Workers Compensation. We may cancel this Policy by mailing or delivering to the first Named Insured written notice of cancellation at least: Ten (10) days before the effective date of cancellation if we cancel for non-payment of premium; or Thirty (30) days before the effective date of cancellation if we cancel for any other reason. CERTIFICATE HOLDER CANCELLATION Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 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 NORA WOLKOFF @ 1988-2015 ACORD ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD , a � ivtant�ernenc vrwsi0n Ali c REVIEWED &APPROVED BY. Aa *44 Risk Management Specialist