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An 1e Digitally signed
<br />a� or CERTIFICATE OF LIABILITY INSURANCE by
<br />ngle3/ozrzozzYY)
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS U H E h R. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED F.y THP��W^I=R
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE CONTRACT BETWEEN THE ISSUING INSURFA(S), AM2Q*3:07
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSUP617, provisions fir 116 01rdlerA
<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 endorsement(s).
<br />PRODUCER
<br />CONTACT Certificate Issuance Team
<br />NAME:
<br />Comprehensive Insurance Services
<br />AIC NNo Ex : (949) 709-8800 FAD No: (949) 709-1668
<br />26420 Rancho Parkway South
<br />poliRless: Jeremy@thecomprehensivelnsurance.com
<br />Suite 120
<br />INSURERS) AFFORDING COVERAGE
<br />NAICn
<br />Lake Forest CA 92630
<br />INSURERA: Nonprofits Insurance Alliance of California
<br />10023
<br />INSURED
<br />INSURER B: StarNet Insurance Company
<br />40045
<br />Delhi Center
<br />INSURER C:
<br />505 E. Central Ave.
<br />INSURER D :
<br />INSURER E :
<br />Santa Ana GA 92707
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: CL2111205495 RRVICIr1N NIIMRFR•
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />INSD
<br />Me
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYYV
<br />POLICY EXP
<br />MMNDIYYYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />®OCCUR
<br />CLAIMS -MADE
<br />PREMISES Ea occurrence)$
<br />500,000
<br />MED EXP (Any one person)
<br />$ 20,000
<br />PERSONAL&ADV INJURY
<br />$ 11000,000
<br />A
<br />Y
<br />2021-01376
<br />11/0112021
<br />11/01/2022
<br />GEN'L AGGREGATE LIMITAPPLIES PER:
<br />GENERALAGGREGATE
<br />$ 3,OOD,000
<br />❑ PRO-
<br />FX—I
<br />POLICY JECT LOC
<br />PRODUCTS - COMPIOP AGG
<br />$ 3,000,000
<br />OTHER:
<br />$0 Deductible
<br />$
<br />LIABILITY
<br />COMBINE. SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY (Per Person)
<br />$
<br />ANYAUTO
<br />AOWNED
<br />SCHEDULE.
<br />UTOS ONLY AUTOS
<br />2021-01376
<br />11/01/2021
<br />11/01/2022
<br />4MOBI,LE
<br />BODILY INJURY Per accident
<br />I )
<br />$
<br />HIREDNON-OWNEDPR
<br />ONLY AUTOS ONLY
<br />DAMAGEUTO
<br />Per accident
<br />$
<br />$0 Deductible
<br />$
<br />X
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />A
<br />EXCESSLIAB
<br />CLAIMS -MADE
<br />2021-01376
<br />03/02/2022
<br />11101/2022
<br />DED I I RETENTION $
<br />$
<br />WORKERS COMPENSATION
<br />_
<br />X STATUTE FIR
<br />$0 Deductible
<br />AND EMPLOYERS' LIABILITY YIN
<br />E.L. EACHACCIDENT
<br />$ 1,000,000
<br />B
<br />ANY PROPRIETORIPARTNER/EXECUTIVE
<br />OFFICERIMEMBER EXCLUDED? EE
<br />NIA
<br />BNUWC0152622
<br />11/01/2021
<br />11701/2022
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory In NH)
<br />If yes, descrlbe under
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,O00,000
<br />DESCRIPTION OF OPERATIONS below
<br />Social Service Professional Liability
<br />$3,000,000/1,000,000
<br />Aggregate/Occurr.
<br />A
<br />Improper Sexual Conduct Liability
<br />2021-01376
<br />11/01/2021
<br />11/01/2022
<br />$1,000,000/1,000,000
<br />Aggregate/Occurr.
<br />$0 Deductible
<br />DESCRIPTION OF OPERATIONS LOCATIONS; VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />City of Santa Ana, officers, agents, employees, and volunteers are named as additionally Insured on this policy pursuant to written contract, agreement, or
<br />memorandum of understanding per attached endorsement CG2026. Such insurance as is afforded by this policy shall be primary, and any insurance carried
<br />by Clly shall be excess and noncontributory per attached endorsement NIAC E61. 30 day notice of cancellation with 10 day notice of cancellation for
<br />non-payment of premium per policy provision. Umbrella policy applies over and above General Liability coverage.
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza
<br />Santa Ana
<br />CA 92702
<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 />AUTHORIZED REPRESENTATIVE
<br />ArnR
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />3 ^_a Risk Management
<br />j Hf REVIEWED & APPROVED BY:
<br />lfi�ila r1r.11' A r"n ewk
<br />T Risk Management Spedalist'
<br />
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