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Digitally signed by Francine R. Francine R. Villareal Villareal A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 02/04/2022 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(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 CONTACT DiAnna Martin NAME: All -Cal Insurance Agency ACNE. Ext : (916) 784-9070 a/c, No): (916) 784-0158 505 Vernon Street E-MAIL dianna@all-calinsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Roseville CA 95678 INSURERA: Nonprofits' Insurance Alliance of California 011845 INSURED INSURER B The Los Angeles Dream Shapers INSURER C : P.O. Box 3831 INSURER D : INSURER E : Orange CA 92865 INSURER F : COVERAGES CERTIFICATE NUMBER: CL216710291 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. INSR LTR TYPE OF INSURANCEAUULbUBK INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREM SES Ea 0.urrrence $ 500,000 X MED EXP (Any one person) $ 20,000 Liquor Liability Coverage $ 1,000,000 / 1,000,000 PERSONAL &ADV INJURY $ 1,000,000 A Y Y 2021-08609NPO 06/02/2021 06/02/2022 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 ❑ PRO X JECT LOC PRODUCTS-COMP/OPAGG 2,000,000 $POLICY $ X1 OTHER: No Deductible AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y 2021-08609NPO 06/02/2021 06/02/2022 BODI LY I NJ U RY (Pe r accide nt) $ X PROPERTY DAMAGE Per accident $ HIRED �/ NON -OWNED AUTOS ONLY X AUTOS ONLY Comp & Coll Deductible $ 500 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ElN OFFICER/MEMBER EXCLUDED? /A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, its officers, employees, agents and representatives are additional insured with respect to General and Auto Liability per the attached endorsement as required by written contract. Insurance is Primary and Non -Contributory, 30 Days Notice of Cancellation with 10 Days Notice for Non -Payment of premium in accordance with policy provisions. Forms CG 20 26, NIAC-E61, NIAC-E26 and NIAC-Al apply. 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 @ 1988-2015 ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD cF RA Management Division REVIEWED & APPROVED BY.- -� Risk Management Analyst