FAMILIES TOGETHER OF ORANGE COUNTY

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A-2021-107-04B e Digitally signed by Framine R. Francine R. Villareal"mgla,aM 66ie: 2021n. In 1111.1 ACO/ZO CERTIFICATE OF LIABILITY INSURANCE DATE(MMID2[NYYY) �� 7/z7/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND ORALTER 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(les) must 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 NAME Sandra Cox Lake Insurance Agency 653 South B Street PNCN o Ed(714)263-3600 - qlc No: 17141263-ss09 EMAIL ADDRESS• Sandra@lakeins.com L1C #0747473 INSURERS AFFORDING COVERAGE NAIC N INSURERA: The Hanover Insurance Company 22292 Tustin CA 92780 INSURED INSURERB:Em lorex2 Preferred Insurance Company 10346 INSURERC: Families Together of Orange County 661 W. 1st, kG INSURERD: INSURER E: Tustin CA 92780 INSURERF: 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 OFANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO 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 R TYPE OF INSURANCE AODL BUBB POLICYNUMBER POLICYEFF MMIDOlY=XI POLICYEXP (MMIDONYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIM&MADE ❑X OCCUR EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occunebca $ 1,000, 000 MED EXP (Any one person) $ 10,000 X ZDIR10874802 11/6/2020 11/6/2021 PERSONAL &ADV INJURY $ 11000,000 GEN'LAGGREOATE LIMITAPPLIES PER: X POLICY ❑ JPEC LOC GENERALAGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE -LIMIT Ea ...Went)_ $ 1,000,000 X Per person) BODILY INJURY '(I'., $ A ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS AWIH099975 11/6/2020 11/6/2021 BODILY INJURY P ,abcldenq ( e $ NON-0WMED HIRED AUTOS AUTOS PROPERTYOAMAGE Per ascidpar $ $ X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 4 000,000 AGGREGATE $ 4,000,000 A EXCESS LIAR CLAIMS -MADE DED X RETENTION $ 10 000 URIH423239 11/6/2020 11/6/2021 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN X PER OTH- STATUTE ER E.L. EACH ACCIDENT if . 1.000,000 B ANY PROPRIETORJPARTNERIEXECUTNE ❑ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under NIA SI0250255304 5/16/2021 5/16/2022 E.L. DISEASE - EA EMPLOYEE $ 11000,000 E.L. DISEASE -POLICY LIMIT $ 1, 000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remark. Schedule, may be attached if more space is required) The City of Santa Ana, its Officers, Agents Employees and Representatives are Additional Insured as respects general liability per CG 20 26 04 13. Coverage is primary and noncontributory per endorsement 421-2915 06 15. L.rn I IrIL.AI C nVLUMM The City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 ACORD 25 (2014101) INS025 (201401) 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 ie Toby/SANDRA The ACORD name and logo are registered marks of ACORD Rielc MuerlEDtvlatml pREVIEWED kIAgPPROVED BY: i� R1sk NlaRagement AnalysE.s