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<br />CERTIFICATE OF LIABILITYAI I"N;kE kti er,ra�4VOs/2o22
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFER E CERTIF L 4TTEEFFjjEEOLLQQDE*�R.H77I__S''
<br />CERTIFICATE DOES NOT AFFIRMATIVELY NEGATIVELYALTEOTHEAGE AFFOR 11
<br />CMf
<br />RDO
<br />T IS CERTIFICATE OF INSURANCE ESCO ST TUTE A CONTRACT BRTWE N THE ISSUING
<br />BELOW.F CI AER(S,'Al1Tf10TL12ED'
<br />SUG
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. If n n+
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) mu h O L IslitniS b E..._
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an Anclorsern A on I 1
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). I .L3.J 7 207 00
<br />PRODUCER
<br />_
<br />CONTACT Certificate I$suanDE Fe'.,n
<br />NAME:
<br />Comprehensive Insurance Services
<br />PHONE (949) 709-8800 F^X (949) 709-1668
<br />AIC No Ezl: A/C No:
<br />26429 Rancho Parkway South
<br />no0aE55: jeremy@thecomprehensiveinsumnce.com
<br />Suite 120
<br />INSURER a AFFORDING COVERAGE
<br />NAIC N
<br />Lake Forest CA 92630
<br />INSURERA: Nonprofits Insurance Alliance of California
<br />10023
<br />INSURED
<br />INSURER B: Security National Insurance Cc
<br />33120
<br />KldWorks Community Development Corporation
<br />INSURER C:
<br />1902 W. Chestnut Ave.
<br />INSURER D:
<br />INSURER E:
<br />Santa Ana GA 92703
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: CL216705234 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FORTHE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO WHICH THIS
<br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />LTR
<br />TYPE OF INSURANCE
<br />POLICYNUMBER
<br />F
<br />MMIUDIYYYY
<br />POLICY EXP
<br />M/ MDD
<br />LIMITS
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMSMAOE iJ OCCUR
<br />EACH OCCURRENCE
<br />$ 1.000,000
<br />PREMISES Ea occurrence
<br />$ 500,000
<br />MEO EXP (Any one emon
<br />$ 20,000
<br />PERSONAL XADV INJURY
<br />$ 1,000,000
<br />A
<br />Y
<br />Y
<br />2021-45659
<br />07/01/2021
<br />07/01/2022
<br />GEWLAGGREGATE LIMITAPPLIES PER:
<br />POLICY JECTT ® LOC
<br />GENERALAGGREGATE
<br />g 3,000,000
<br />PRODUCTS-COMP/OPAGG
<br />$ 3,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINEOSINGLE LIMIT
<br />Ea acciden
<br />$ 1,000.000
<br />BODILY INJURY (Per person)
<br />$
<br />ANYAUm
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />2021-45659
<br />07/01/2021
<br />07/01/2022
<br />BODILY INJURY (Par accident)
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTYDAMAGE
<br />Per accident
<br />$
<br />x
<br />UMBRELLALIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />A
<br />EXCESS LIAB
<br />CLAIM&NADE
<br />2021-45659-UMB
<br />07/01/2021
<br />07/01/2022
<br />DEO I I RETENTION $ 10000
<br />B
<br />WORKERSCOMPENSATION YIN AmON
<br />AND EMPLOYERS'LIABILITY
<br />ANY PROPRIETORIPARTNERIEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatory In NH)
<br />If yes, descdbe under
<br />DESCRIPTION OF OPERATIONS below
<br />N/A
<br />SNP1374003
<br />02/01/2022
<br />02/01,2023
<br />PER OTH-
<br />GTATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE -EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />Social Service Professional Liability
<br />Improper Sexual Conduct Liability
<br />2021-45659
<br />07/01/2021
<br />07/01/2022
<br />$1.000,000/1,000,000
<br />$3,000,00011,000,000
<br />Aggregate/Occurr.
<br />Aggregate/Occurr.
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space Is required)
<br />City of Santa Ana its officers, officials, employees and volunteers are mcldued as Additional Insured automatically per written contract or agreement per
<br />attached endorsement CG2026 and CG 2037. 30 day notice of cancellation with 10 day notice of cancellation for non-payment of premium per policy
<br />provision. Such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit
<br />of the additional insureds per attached endorsement NIAC E61. Waiver of Subrogation applies per attached endorsement NIAC E26.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92701 ,e. �J„,,• RiefeMRruganattDMeWn
<br />©1988-2015 ACOF I ` h Xj, t Auva(n
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD i®' Risk Management specialist
<br />
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