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Francine R. ` Digitally signed byeandne a.
<br />'kVIgnal
<br />.i111areal /„npgzol.oa n:ianl
<br />A o° CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIDDIYyyy)
<br />12/29/2021
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(kas) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, sub)ect to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rl hts to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Bolton Insurance Services LLC
<br />3475 E. Foothill Boulevard
<br />Suite 100
<br />Pasadena, CA 91107
<br />NXMTEACT
<br />PHONE
<br />A/C, No, Ext: (626) 799-7000 FAX No :(626) 441-3233
<br />FAiy lLss:
<br />INSURERS AFFORDING COVERAGE
<br />NAIC If
<br />INSURED
<br />Wiseplace, CA Corp. Wise Silver Center dba:
<br />1411 N. Broadway
<br />Santa Ana, CA 92706
<br />INsuRERA:Tokio Marine Specialty Insurance Company
<br />INSURERB;Amerlcan Healthcare Indemnity Company
<br />23850
<br />39152
<br />INSURER C: Philadelphia Indemnity Insurance Company
<br />INSURER D:
<br />18058
<br />INSURER E;
<br />INSURER F :
<br />THIS
<br />INDICATED.
<br />CERTIFICATE
<br />EXCLUSIONS
<br />INSR
<br />__.....
<br />IS TO CERTIFY THAT THE POLICIES
<br />NOTWITHSTANDING ANY
<br />MAY BE ISSUED OR MAY
<br />AND CONDITIONS OF SUCH
<br />TYPE OF INSURANCE
<br />._..._,-,......�...
<br />OF
<br />REQUIREMENT,
<br />PERTAIN,
<br />POLICIES.
<br />ADDL
<br />p
<br />INSURANCE
<br />SUBR
<br />LISTED BELOW HAVE BEEN
<br />TERM OR CONDITION OF
<br />THE INSURANCE AFFORDED BY
<br />LIMITS SHOWN MAY HAVE BEEN
<br />POLICY NUMBER
<br />ISSUED
<br />ANY CONTRACTOR
<br />THE POLICIEH
<br />REDUCED BY
<br />POLICY EFF
<br />11112022
<br />TO THE INSURED
<br />OTHER
<br />S DESCRIBED
<br />PAID CLAIMS.
<br />POLIC�Y EXP
<br />tYYYYj
<br />1/1/2023
<br />KCVISIUN NUMBER:
<br />NAMED ABOVEFOR
<br />DNAMED ABOV RESPECT
<br />HEREIN IS SUBJECT
<br />LIMITS
<br />THE POLICY PERIOD
<br />TO ICY PERIOD
<br />THIS
<br />TO ALL THE TERMS,
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS MADE OCCUR
<br />X
<br />PHPK2357925
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTEDPREMISES (ED e
<br />$ 100,000
<br />MED EXP (AnY onePerson)
<br />$ 5,000
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />A
<br />925
<br />111/2022
<br />11112023
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY �JECT LOG
<br />oTHEft:
<br />AUTOMOBILE LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOSONLY SAUTOSCHED ,r
<br />X AUR OS ONLY X NON-O IN&D
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />PRODUCTS - COMPIOP AGO
<br />$ 2,000,00O
<br />SEXUAL PHYSICAL
<br />COMD SINGLE LIMIT
<br />Ea DM nt
<br />BODILY INJURY per Daemon)
<br />1,000,000
<br />$ 1,000,000
<br />$
<br />BgOOPERDILY NVU A�AGEaccltlent
<br />$
<br />q
<br />Peraccij
<br />$
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />A
<br />B
<br />A
<br />C
<br />X UMBRELLA LIAB X OCCUR
<br />EXCESS LIAe CLAIMS-MADE05
<br />925
<br />604
<br />j
<br />11112022
<br />8/1512021
<br />1/112022
<br />515/2021
<br />1/1/2023
<br />AGGREGATE
<br />$ 1,000,000
<br />DED X RETENTION$ 10,000
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOWPARTNER/EXECUTIVE YIN601
<br />OFFICER/MEMBER EXCLUDED?
<br />,Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />Professional Liab.
<br />Employee Theft -
<br />Personal & Adv
<br />PER OTH-
<br />X TUTE R
<br />1,000,000
<br />8/1512022
<br />1/1/2023
<br />61912022
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYE
<br />$ 1,000,000
<br />E. L. DISEASE - POLICY LIMIT
<br />Occurrence
<br />NIA
<br />1,000,000
<br />1,000,000
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />GL Additional Insured applies per CG20130413 attached, only if required by written contract/agreement.
<br />Primary and Non -Contributory Wording applies per PIGLOO50712 attached.
<br />Notice of Cancellation applies per IL00171198 attached,
<br />Additional Insured(s): City of Santa Ana, Its officers, employees, agents, volunteers and representatives.
<br />RE: Operations of the named Insured.
<br />reoTIC10 C unr ncn
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City Of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza, 4th floor
<br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE
<br />% 'AP RM91W.nsgvmp4Dhblon.
<br />- REVIEWEV,16APPROV®SY::
<br />ACORD 25 (2016103) ©1988-2015 ACORD C
<br />The ACORD name and logo are registered marks of ACORD /Jk'ytpgIX'Itv,f
<br />
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