Laserfiche WebLink
lly signby Ton Pirson <br />Tori Pierson Dag1e 2022,01e180935:51e OB'00' <br />A� o® CERTIFICATE OF LIABILITY INSURANCE <br />1zD/z9GATE v20120IY1 <br />z1 <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 endomement(s). <br />PRODUCER <br />Comprehensive Insurance Services <br />26429 Rancho Parkway South <br />Suite 120 <br />Lake Forest CA 92630 <br />CONTACT Certificate Issuance Team <br />NAME: <br />PNCNn E (949) 709-8800 FAX No: (949) 709-1668 <br />E-MAILss: Jeremy@thecompmhensiveinsurance.com <br />ADDR <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />INSURERA: Nonprofits Insurance Alliance of California <br />10023 <br />INSURED <br />Child Creativity Lab, Inc. <br />1901 E. Carnegie Ave. <br />Unit I <br />Santa Ana CA 92705 <br />INSURER B: Property & Casualty Insurance Company of the Hartford <br />34690 <br />INSURER C: <br />INSURER D <br />INSURERE: <br />INSURER F: <br />Cr1VFRAriFS CERTIFICATE NUMBER: CL217805279 REVISION NUMBER: <br />THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD <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 />ILTR <br />TYPE OF INSURANCE <br />INSD <br />MD <br />POLICY NUMBER <br />POLICYEFF <br />MMIDOIYYYY <br />POLICYTY1 <br />MMIDDr EXP <br />LIMITS <br />COMMERCIAL GENERALLIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />CLAIMS -MADE � OCCUR <br />PREMISES Ea occurrence <br />$ 500,000 <br />MED EXP (Any one eMDn) <br />$ 20,000 <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />A <br />Y <br />Y <br />2021-43549 <br />08/01/2021 <br />08/01/2022 <br />DEVIL AGGREGATE LIMIT APPLIES PER: <br />GENERALAGGREGATE <br />$ 3,000,000 <br />PRODUCTS-COMPIOPAGG <br />$ 3,000,000 <br />POLICY JECT � LOC <br />$ <br />OTHER <br />AUTOMOBILE LIABILITY <br />COMBI NED SINGLE LIMIT Ea amitlent <br />s 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />AI <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY !H AUTOS ONLY <br />2021-43549 <br />09/01/2021 <br />08/01/2022 <br />BODILY INJURY (Per acddent) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />8 <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED <br />I I RETENTION $ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANYPROPMETORIPARTNENEXECUTIVE OFFICERIMEMBER EXCLUDED? <br />(Mandatory in NH) <br />NIA <br />72WECAK2JDW <br />01/26/2021 <br />01/26/2022 <br />l PER <br />! STATUTE EORTM <br />E.EACH ACCIDENT <br />L. <br />$ 1,000,000 <br />E.L. DISEASE - FA EMPLOYEE <br />$ 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$ 1,000,000 <br />$2,000,000 Aggregate <br />A <br />Improper Sexual Conduct Liability <br />2021-43549 <br />08/01/2021 <br />08/01/2022 <br />$1,000,000 Each Claim <br />DESCRIPTION OF OPERATIONS l LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) <br />The City of Santa Ana, its officers, officials, employees, agents, and volunteers are included as Additional Insured automatically per written contract or <br />agreement per attached endorsement CG2010. Waiver of Subrgoation applies per attached endorsement NIAC E26. 30 day notice of cancellation with 10 <br />day notice of cancellation for non-payment of premium per policy provision. This insurance is Primary and Non-contributory NIAC E61. <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana <br />ACORD 25 (2016103) <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 />CA 92702 <br />1tbk ManrgalvalpHNon <br />@1988-2015 ACORD CO R`aEmIED&AmencemBY: - <br />Wit 7pu Prcwdn <br />The ACORD name and logo are registered marks of ACORD <br />abxnla„aee�rx,namralad< <br />