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Ac o® CERTIFICATE OF LIABI ITY INSURANCE L)Iglt �"'g0
<br />022
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND C I� I N THE CEI TI -�E S
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEN O q T GE AFFO' .� E TNCIE
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BEAY N THE ISSUING I' .SL 115R($),�J1J�O�Z�D
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. VV VV
<br />�%TT-CC
<br />ORTANT: If the certificate holder is an NAL f III
<br />m
<br />Dterms 0
<br />J
<br />If SUBROGATION 5 WAVED, subject to the and condition of this
<br />eopo IIIin �es da re
<br />nqns ttftl 05 1
<br />this certificate does not confer rights to the certificate holder in lieu of such d V
<br />PRODUCER
<br />CONTACT Certificate Issuarce"eam
<br />NAME:
<br />_
<br />Comprehensive Insurance Services
<br />_
<br />(949) 709-P,00 7 - 668
<br />VCNN . Arc No :(49)
<br />26429 Rancho Parkway South
<br />E-MAIL jeremy@the;c.ipmhensiveinsurance.com
<br />ADDRESS: ,pmhensiveinsurance.com
<br />$U118120
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC Is
<br />INSURERA: Nonprofits Insurance Alliance of California
<br />10023
<br />Lake Forest CA 92630
<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 CA 92707
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: CL2111205495 REVISION NUMBER -
<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 />T R
<br />TYPE OF INSURANCE
<br />IN50
<br />MO
<br />POLICY NUMBER
<br />POLICYEFF
<br />MM/ODAEFF
<br />POLYEXP
<br />POLIC
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE © OCCUR
<br />PREMISES Ea ocwTen ca
<br />$ 500,000
<br />MED EXP (Any one mon)
<br />$ 20,000
<br />PERSONAL B ADV INJURY
<br />$ 1,000,000
<br />A
<br />Y
<br />Y
<br />2021-01376
<br />11/01/2021
<br />11/01/2022
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERALAGGREGATE
<br />$ 3,000,000
<br />POLICY PROJECT- ® LOC
<br />PRODUCTS-COMP/OP AGO
<br />$ 3,000,000
<br />$0 Deductible
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accidm
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />AWAUTO
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />2021-01376
<br />11/01/2021
<br />11/01/2022
<br />BODLYINJURY(Peraceiden0
<br />$
<br />HIRED NON -OWNED
<br />X
<br />PROPERTYDAMAGE
<br />Per accident
<br />$
<br />AUTOS ONLY AUTOS ONLY
<br />$0 Deductible
<br />$
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />A
<br />!xfESS LIAB
<br />Cl-AIMS-MADE
<br />2021-01376
<br />03/02/2022
<br />11/01/2022
<br />DEG_RETENOON $
<br />$
<br />WORKERS COMPENSATION
<br />PER I I OTK
<br />$O Deductible
<br />AND EMPLOYERS' LIABILITY Y
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />B
<br />ANY PROPRETORIPARTNERIExECUTIVE �I
<br />OFFICERIMEMBER EXCLUDED?
<br />BNUWC0152622
<br />11/01/2021
<br />11/01/2022
<br />E.L. DISEASE - EA EMPLOYEE
<br />S 1,000,000
<br />(Mandatory In NH)
<br />Ifyes, cosmos under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POUCY LIMIT
<br />$ 1,000,000
<br />$3,000,000/1,000,000
<br />Aggregate/Occurr.
<br />Social Service Professional Liability
<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 I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N 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 City 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. Waiver of Subrogation applies per
<br />attached endorsement NIAC E26.
<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 />©1988.2015 ACOF
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />fit, RWeMRwganati.Dtvieiprt
<br />REVIEWED 6 APPROVED BY:
<br />Rbk Management Speoalist
<br />01
<br />
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