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iitC-C�M/J CERTIFICATE OF LIABILITY INSURANCE DAT11/021EIMM2/22807 7 <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 />HM—POITT—ANT; "a contficate holder In an ADDITIONALIf SUBROGATION IS WAIVED, subject to the ttermsa and conditions oftheDl policy, <br />es)must olio TIONAL INSUREDrsement. orbeendorsed. <br />1 p oy, certain mm nt(s).as may require an endorsement. A statement on <br />this certificate does not confer rIDIHa to the certificate holden in lieu of such endoreement(S , <br />PRODUCER SO Or NAME' 66N Cer00oate lance Team �.,. <br />Comprehensive lnaurence Services PHONE <br />UQ.M �0 . (949)709.8800 a <br />26429 Rancho Parkway South . M. <br />Ir <br />ADDRESS: y@thecomprehonslvelmumnce.cam <br />(B49)709-i66B <br />Suite 120 INSURIDUSIAFfORDIMOCOVEMGE -NAICB <br />Lake Forest CA 92830 msUREan: Nonprofits Insurance Alliance of California 10023 <br />INSURED MSURERa: StarNat Insurance Company - - 40046� <br />Delhi Center INSURER a: <br />505 E, ContlalAVe, INSURER D: <br />N8anE <br />Santa Ana CA 92707 INSURER!: <br />COVERAGES CERTIFICATE NUMBER: CL2111205495 REVISION NUMBER: <br />THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDINGANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, <br />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />L}R TYPE OPINSUMNCE I <br />Ix <br />..R9.11 POUCYNUYBER MMNDIYYYY MOWN V, <br />UMne <br />GONMFRCIAL GENERAL UASWITY EACHOCWNRENCE S 1.000.000 <br />CLAIM8•MAOE ® OCCUR PREM18E5mx nrb,nnnrwl f 500J000 <br />A <br />J <br />Y <br />2021-01376 <br />1110112021. <br />11ION2022 <br />PERSONAL Nnpy INJURY <br />7,tl0D,000 <br />OENLAGGRFOATE LIMITAPPLIES PER: <br />GENERALAGGREGATE <br />§ 9.060,000 <br />POLICY ® JECT ®LOC <br />PRODUCTS-COMPIOPAGG <br />§ 3,C00,000 <br />OTHER: <br />$O Deductible <br />AUTOMOBILE LWBILRY <br />INW I <br />Ee ectid <br />§ 1,000,000 <br />ANYAUTO <br />9pDILYINJURY(P.pg ) <br />§ <br />A <br />OWNED BCHEOULED <br />AUTOS ONLY AUTOS <br />2021-01376 <br />11/01/2021 <br />1110112022 <br />aoDRYIWURY(P.,Z&nn <br />§ <br />HIRED NO"MED <br />AUTOS ONLY AUTOGONLY <br />-s <br />v..�. <br />0 Deductible <br />UMBRELLA LOOP OCCUR <br />EACH OCCURRENCE <br />excess L1AB GlA1M6 Mn0F <br />AGGREGATE <br />DED - RETENTION $ <br />§ <br />WORKERS COMPENSATION <br />X PER <br />$O DBdUCIIbIB <br />AND EMPLOYERS' LUMILRY YIN <br />STATUTE <br />B <br />ANYPROPRIEiORIPARTNERIEXECUMVE LNJ <br />ppFflCEriMEMOCR EXCLUDED? <br />NIA <br />13NUWC0152622 <br />11/0112021 <br />1110V2022 <br />E.L. EACHACCIOEW <br />II1,000,000 <br />E.L DISEASE - EA EMPLOYEE <br />$ 1,000,000 r <br />tMnndalNry to NH) <br />_ <br />nron.d.fte enggr <br />DESCRIPTION OF OPEMTIONShBNw <br />_ <br />E.L. DISame-POR'"Le"n <br />S 1,000,000 <br />ServiceProfessionalConduct <br />$$,000,000/1.000,Wo <br />ABgregom Om1R. <br />A <br />ImpSocroper <br />Improper Sexual Conduct Liability <br />Liability <br />2021-01376 <br />11101/2021 <br />11101/2022 <br />$1.000'000/1,O.OLCCO <br />Aggregated0ccun. <br />$D DadUoUble <br />DESCRIPTION OF OPEANDONS I LOGATIDNS I VEHICLES (ACORD 101. AVVmond RnmvhA Saboduk, niW he MWah" It rune npnae In mqulmr0 <br />City of SMIWAWU ONcere, agents, employees, end VOlmleum are named aS additionally Insured on this policy pursuant to written contrast, agreement, or <br />memorandum of understanding per attached endomemant CG2026. Such insurance as is afforded by this policy shall be primary, and any insurance carried <br />by Cary shall be excess and nonaonmbutory per attached endamement HAIG E61. 30 day notice of cancellation With 10 day notes, of cancellation for <br />non-payment of premium per policy prevision. <br />PPOTIFIr.ATC wen nwo <br />SHOULD ANY OF THEASOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Division <br />AUTHORReD REPRESENTATIVE <br />20 CIVIC Center Plaza <br />Santa Ana CA 92702 <br />®1955-ZUIB ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010103) The ACORD name and logo are registered marks of ACORD <br />