COMMUNITY HEALTH INITIATIVE OF ORANGE COUNTY (3)

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Francine R. mqu:IynO„m Wraonocz V111-1 Villareal wr:: annoao a.' 3 mna ACORO® CERTIFICATE OF LIABILITY INSURANCE lasi DATE(MMMDNYYY) 1 09/27/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Certificate Issuance Team NAME: Comprehensive Insurance Services 26429 Rancho Parkway South PRONE L.t (949) 709-8800 F No : (949) 709-1668 E-MAIL jerem theoom rehensiveinsurance.com ADDRESS: y� P Suite 120 INSURERS AFFORDING COVERAGE NAIC4 Lake Forest CA 92630 INSURERA: Nonprofits Insurance Alliance of California 10023 INSURED INSURER B Community Health Initiative of Orange County INSURER C: 1505 E. 17th Street, Suite 121 INSURER INSURER E: Santa Ana CA 92705 1 INSURER F: COVERAGES CERTIFICATE NUMBER: OLZ192705434 RFVICIr1N NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD WVI3 POUCYNUMBER POLICY EFF MMIDDfYYYY) POLICYEXP UMMIDDYYYYI LIMITS x COMMERCIAL GENERAL ABILITY CLAIMS -MADE � OCCUR EACH OCCURRENCE $ 1.000,000 PREMISES Ea occurrence)E $ 500,000 MED EXP (Any onePerson) $ 20,000 PERSONAL& ADV INJURY $ 1,000,000 A Y 2021-44927 10/15/2021 10/15/2022 GEN'LAGGREGATE UMITAPPLIES PER: POLICY ❑ JECT IE LOC GENERALAGGREGATE $ 2.000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $0 Deductible $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,DOO,000 BODILY INJURY (Per Person) $ ANYAUTO A OWNED CHODLED AUTOSONLV AUT& -4927 10/15/2021 10/15/2022 BODILY INJURY (Per ecutlent $ X HIRED NON -OWNED AUTOSONLY AUTOS ONLY PROPERTY DAM GE Per accident $ $0 Deduclible $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS UAB CIAIMS-MADE OED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA PER OTH- STATUTE ER E.L EACH ACCIDENT $ EL DISEASE - EA EMPLOYEEIf $ (Mandatory in NH) yes, describe under EL DISEASE -POLICY LIMIT $ DESCRIPTION OFF DESCRIPTION OF OPERATIONS below A Social Service Professional Liability Improper Sexual Conduct Liability 2021-44927 10/15/2021 10/15/2022 $1,000,000/1,000,000 $1,000.000/1'000,000 Aggregate/Occ Aggregate/Oce $0 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be allached if more space is required) City of Santa Ana, officers, agents, employees, and volunteers are included as additionally insured on this policy pursuant to written Contract or written agreement per attached endorsement NIAC E61. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and noncontributory per attached endorsement NIAC E61. 30 day notice of cancellation with 10 day notice of cancellation for non-payment of premium per policy provision. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza Santa Ana CA 92702 v _ RIA Muu omeartDivision REVIEWED & APPROVED BY: ©18as-201COR °i5 A`'�s iM1. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD '®' Risk Managenlenr Anatysr