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ONM�Y�'1 Digitally O 6g I e Si ned b TQRRE Ar gieDAKEgNa4DVYYV) CERTIFICATE OF LIABILITY INSURAN b te: 2l2512022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPOCeV N THE Cr.RTIF2022.7MMIER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COV GE At FURQQ��QQ��S5 111iE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN 1I;if:G IN SURER�AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. UUttff 00ooff 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 endorsements) PRODUCER License 100757776 1 cpj)TACT Diana DeLaTorre HUB International Insurance Services Inc 4695 MacArthur Court Suite 600 Newport Beach, CA 92660 INSURED OneOC 1901 E. Fourth Street, Suite 100 Santa Ana, CA 92705 COVERAGES CFRTIFICATF NIIMRFR• ov,ncrnur uu Ifta—.. 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 T TYPE OF INSURANCE qNS SUBR POLICY NUMBER PO LDICCYEFF 111512022 POLICYEXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR X X PHPK2369594 111512023 EACH OCCURRENCE $ 1,000,000 DAMAGE TORENTurz0ence $ 100000 MEDEXP An one erson $ 5,000 — PERSONAL &ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY❑ PEO E LOG GENERALAGGREGATE AM001000 GEN'L X PRODUCTS-COMP/OPAGG $ 3,000,000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) 11000,000 X ANY AUTO OWNED SCHEDULED AUTOS ONLY X AUTOS Epp AUTOS ONLY X AUTOS ONFILV X X PHPK2369594 1/1512022 1115/2023 BODILY INJURY Perperson) BODILY INJURY Per accident FOPcclG n AMAGE A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PHUB800132 111512022 1/75/2023 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 DED X RETENTION$ 10,000- WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PR�O��PRIETORIPARTNERIEXECUTIVE 1Mandats aBER EXCLUDED? NH) If yas, describe under DESCRIPTION OF OPERATIONS below NIA PER OTH- S E E E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE E.L. DISEASE -POLICY LIMIT A Sexual Abuse PHPK2369594 1/15/2022 1115/2023 Each Abuse 1,000,000 A Prof. Liability PHPK2369594 1/15/2022 1115/2023 Aggregate Limit 3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if mores ace is required) RE: MPNA GREEN Programs Revive: Santa Ana Food Supply/Distribution Programs RFP: No.: 22-009rk City, Its officers, officials, employees, and volunteers are additional insured on a primary and non contributory basis as respects to General Liability as required by written contract. General Liablity Waiver of Subrogation also applies per same form as required by written contract. Automobile Liablity Additional Insured on a primary and non contributory basis as respects to General Liability as required by written contract applies as per form to follow from carrier. Automobile Liablity Waiver of Subrogation also applies per same form as required by written contract as per form to follow from carrier. SEE ATTACHED ACORD 101 City of Santa Ana 20 Civic Center Plaza PO Box 1988 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 ��,{{RR�,E..PP- REPRESENTATIVE 1.PM.�C=%LL4"d Im— ACORD 25 (2016/03) 01988.2015 ACORD The ACORD name and logo are registered marks of ACORD ,+ "a'ManagL-menl:Dtyulon REVIEWED/&APPROpVB7 BY: '1 i ( �- , Ai uittle, ' IMM,I Risk Management Specialist