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<br />A� RO CERTIFICATE OF LIABILITY INSURANCE
<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 endorsements .
<br />PRODUCER License tf OC32169
<br />CONTACT
<br />Rancho Mesa Insurance Services, Inc.
<br />250 Riverview Parkway-
<br />Santee, CA 92071
<br />PHONE FAX
<br />A/C, No, Ext: (619) 937-0164 AIc, Nei:(619) 937-0168
<br />E-MAIL
<br />s:
<br />INSURERS AFFORDING COVERAGE
<br />NAICM
<br />INSURER A:AFCh Insurance Company
<br />11150
<br />INSURED
<br />INSURER B : Service American lndemnit /COT )aD
<br />39152
<br />INSURER C:
<br />Community Legal Aid SOCal
<br />2101 North Tustin Avenue
<br />Santa Ana, CA 92705
<br />INSURER D
<br />INSURER E
<br />NSURER F :
<br />QDVFRAr.FS r rRTIFIf--ATF NI IMRFR• H ovancrnu en raarsvn.
<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 />IN1. SR
<br />TYPE of INSURANCE
<br />ADDLSUBR
<br />POLICY NUMBER
<br />POLICY Err
<br />POLICY EXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIALGENERAL LIABILITY
<br />CLAIMS -MADE [X] OCCUR
<br />X
<br />AAPKGO046503
<br />9/112021
<br />911/2022
<br />EACH OCCURRENCE
<br />11000,000
<br />DAMAGETO
<br />ERENTED occurrence)1,000,000
<br />EREM[SaMED
<br />EXP (myone rson
<br />25,000
<br />PERSONAL S ADV INJURY
<br />1,000,000
<br />GEN'L
<br />AGGREGATE UMITAPPLIES PER:
<br />POLICY El %coT Fx] LOC
<br />GENERAL AGGREGATE
<br />2,000,000
<br />PRODUCTS-COMP/OPAGG
<br />1 2,000,000
<br />OTHER,
<br />A
<br />LIABILITY
<br />EOMeBIINED SINGLE LIMIT
<br />$ 1,000.00
<br />BODILY INJURY Per arson
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY SAURDSC11L.pD E
<br />Al)TOS ONLY X AUTOS Wb
<br />AAPKGO046503
<br />9/1/2021
<br />9/112022
<br />POMOBILE
<br />BODILY INJURY Per accident
<br />$
<br />RR 0PEd�DAMAGE
<br />$
<br />A
<br />X
<br />UMBRELLAUAB
<br />EXCESS UAB
<br />M
<br />OCCUR
<br />CLAIMS -MADE
<br />AAFXS0046503
<br />9/112021
<br />91112022
<br />EACH OCCURRENCE
<br />$ 3,000,000
<br />AGGREGATE
<br />$ 3,000,000
<br />DED X RETENTION$ O
<br />B
<br />ANDEMPS COMPENSATION
<br />YIN
<br />ANYWe EMEMBER EXCLUDED?ECUTIVE ❑
<br />Wein NH)
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />SATIS0340101
<br />811/2021
<br />911/2022
<br />X PTR ERH
<br />E.L. EACHACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYE
<br />$ 1,000,000
<br />E.L. DISEASE -POLICY LIMB
<br />1,000,000
<br />A
<br />Abuse & Molestation
<br />AAPKGO046503
<br />91112021
<br />911/2022
<br />Occ. $1Ml Aggregate
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule. ma be attached if more space Is required)
<br />RE: OPERATIONS OF THE NAMED INSURED AS CERTIFICATE HOLDERS INTERESIyMAY APPEAR .
<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. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and
<br />noncontributory.
<br />CITY OF SANTA ANA
<br />RISK MANAGEMENT DIVISION
<br />20 CIVIC CENTER PLAZA
<br />SANTA ANA, CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE
<br />THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVi-'--'-
<br />Risk Muugmwl Uiuivan
<br />ITHORIZE/ REPRESENTATIVE
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<br />HbVKLI LO tLUIOIW) ©1938-2015 ACORD C( v
<br />The ACORD name and logo are registered marks of ACORD
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