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i Dlgllally signed by
<br />Samantha '.Samantha M.
<br />i Lambert
<br />ACCMO CERTIFICATE OF LIABILITY INSURAN&amhert DaW29?UT002
<br />DATE(MMIDDmvY)
<br />�-'�
<br />05/09/2022
<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(les) 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 />PaooucER
<br />CONTACTCertificate Issuance Team
<br />NAME:E,
<br />Comprehensive Insurance Services
<br />FHO No Exl : (949) 709-8800 AIC, No: (949) 709-1668
<br />26429 Rancho Parkway South
<br />AOOR..S. Jeremy@thecomprehensivelnsurance.ccm
<br />Suite 20
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC0
<br />LakeF or
<br />e Fore
<br />Lakst CA 92630
<br />INSURER A: Nonprofts 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 uERIIHIGAIt NUMBER- All enncrnra au iaaovn.
<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 />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />WVD
<br />POLICY NUMBER
<br />ICYEFF
<br />MOUC YEFF
<br />PO YEXP
<br />MMIDDIYYYY1
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />URRENCE
<br />$ 1,000,000
<br />l
<br />Ea occurrence
<br />$ 500,000
<br />CLAIMS -MARE OCCUR
<br />Any one maon)
<br />$ 20,000
<br />&ADVINJURY
<br />M
<br />$ 1,000,000
<br />A
<br />Y
<br />2021-09201
<br />12/21/2021
<br />12/21/2022
<br />PER:
<br />GGREGATE
<br />$ 2,000,000
<br />GENTAGGREGATEUMITAPPLIES
<br />-COMP/OPgOG
<br />2,000,000
<br />$OTHER:
<br />POLICY ❑ JECT � LOC
<br />ctible
<br />$
<br />AUTOMOBILE
<br />LIABILITY
<br />SINGLE LIMIT
<br />(E..coldmn
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<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 Per accident
<br />( )
<br />$
<br />X
<br />HIRED v NON -OWNED
<br />AUTOS ONLY /� AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Per accident)
<br />$
<br />$0 Deductible
<br />$
<br />UMBRELLALIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED
<br />I I RETENTION $
<br />$
<br />WORKERS COMPENSATION
<br />v _
<br />STATUTE EqH
<br />$O DedUcflble
<br />AND EMPLOYERS' LIABILITY YIN
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />B
<br />oFFICER/MEM EEXCLUDED? PROPRIETORIPARTNERIEXECUTIVE �
<br />NIA
<br />9255171-22
<br />06/05/2021
<br />06/05/2023
<br />(Mandatory In NH)
<br />If yes, descrMaunder
<br />E.LDISEASE-EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />Soclal Service Professional Liability
<br />$1,000,00011,000,000
<br />Aggregate/Occurr
<br />A
<br />Improper Sexual Conduc[Liabllity
<br />2021-09201
<br />1212112021
<br />12/21/2022
<br />$1,000,00011,000,000
<br />Aggregate/Occurr
<br />$0 Deductible
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required)
<br />The City of Santa Ana, Its officers, officials, employees, and volunteers are Included as Additional Insured per attached endorsement CG2026. With respect
<br />to claims arising out of the operations and uses performed by or on behalf of the named Insured, such Insurance as is afforded by this policy Is primary and
<br />Is not additional to or contributing with any other insurance carried by or for the benefit of The City of Santa Ana, Its officers, officials, employees, and
<br />volunteers per attached endorsement NIAC E61. 30 day notice of cancellation with 10 day notice of cancellation for non-payment of premium per policy
<br />provision. See attached forms list.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLI
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL RenEDBµxy
<br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Management Division �J rt- kMamgm,ent
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92702
<br />@ 1988-2015 ACORD CORPORATION. All rights
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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