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Digitally signed by T.,Pierson <br />Tor( Pierson Date: 2022.06.2809:10:13 <br />)TOer <br />ACORD CERTIFICATE OF LIABILITY INSURANCE <br />DAM(MM/DD/YYYY) <br />05/25/2022 <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(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONT: T Certificate Issuance Team <br />NAME <br />Comprehensive Insurance Services <br />PHON�Eo E (949) 709-8800 � Na: (949) 709-1668 <br />26429 Rancho ParkwaySouth <br />E A L <br />ADDRESS: Jeremy@ihecomprehensiveinsurance.com <br />Suite 120 <br />INSURER S)AFFORDING COVERAGE <br />NAIC p <br />Lake Forest CA 92630 <br />INSURERA: Nonprofits Insurance Alliance of California <br />10023 <br />INSURED <br />INSURER B: State Compensation Insurance Fund <br />35076 <br />Orange County Children's Therapeutic Arts Center <br />INSURER C: <br />2215 N. Broadway <br />INSURER D : <br />NSURER E <br />Santa Ana CA 92706 <br />INSURER F <br />COVERAGES CERTIFICATE NUMBFR. All ocGimnn..' <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 MAY BE 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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />INSR <br />WVO <br />POLICY NUMBER <br />(PULICYEFF <br />MMID0� <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />CLAIMS -MADE N OCCUR <br />PREMISES Ea occurrence <br />$ 500,000 <br />MED EXP (Ary one rson) <br />$ 20,000 <br />PERSONAL BADV INJURY <br />$ 11000,000 <br />A <br />Y <br />Y <br />202149201 <br />12/21/2021 <br />12/21/2022 <br />GEN'L <br />AGGREGATE LIMITAPPLIES PER: <br />PRO-JECT <br />GENERALAGGREGATE <br />$ 3.000,000 <br />PRODUCTS-COMP/OPAGG <br />$ 3,000,000 <br />POLICY ❑ [g LOG <br />$0 DedUctlbla <br />$ <br />OTHER <br />1 <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea acddent <br />$ 1,000,000 <br />BODILY IWURY(Perperson) <br />$ <br />ANYAUTO <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />2021-09201 <br />12/21/2021 <br />12/21/2022 <br />BODILY INJURY Peraccident <br />( ) <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />X <br />PROPERT DAMAGE <br />Per. Went <br />$ <br />$0 Deductible <br />$ <br />UMBRELLALIAB <br />x <br />OCCUR <br />EACH OCCURRENCE <br />$ 1,000,000 <br />A <br />EXCESS LIAR <br />CLAIMS -MADE <br />2022-09201-UMB <br />05/25/2022 <br />12/21/2022 <br />AGGREGATE <br />$ 1,000.000 <br />DEG <br />RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />STATUTE <br />$O Deductible <br />AND EMPLOYERS' LIABILITY Y/N <br />ERTH- <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />B <br />ANY PROPRIETORPARTNER/EXECUTIVE <br />OFFICER/MEMSER EXCLUDED'! <br />N/A <br />9255171-22 <br />06/05/2021 <br />06/05/2023 <br />H) <br />ory in rsibe and er <br />(Mandatory describe <br />( <br />E.L. DISEASE -EA EMPLOYEE <br />S 1,000,000 <br />E.L. DISEASE -POLICY LIMIT <br />E 11000,000 <br />DESCRIPTION OF OPERATIONS below <br />Social Service Professional Liability <br />$110001000/1,000,000 <br />Aggregate/Occun <br />A <br />Improper Sexual Conduct Liability <br />2021-09201 <br />12/21/2021 <br />12/21/2022 <br />$1,000,000/1.000,000 <br />Aggregate/Occurr <br />$0 Deductible <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) <br />The City of Santa Ana, its officers, officials, employees and volunteers are included as Additional Insured automatically per written contract or agreement <br />per <br />attached endorsement CG2010. This insurance is Primary and Non-contributory per attached endorsement NIAC E61. Waiver of Subrogation applies per <br />attached endorsement NIAC E26. 30 day notice of cancellation with 10 day notice of cancellation for non-payment of premium per policy provision. <br />City of Santa Ana <br />Risk Management <br />20 Civic Ctr Piz PO Box 1988 <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 ACORD CDR <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD !•`M idu ptc o.r <br />RBkr&nzgenmr Ocni jhde <br />