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'y Digitallyslgned by Torl Perron <br />TOri Pierson Wtt:2022.06.210e:54s2 <br />-fi700• <br />AC !qbe CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MWOMYYYYI <br />06126/2022 <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(las) must have ADDITIONAL INSURED provisions or be endoreed. <br />If SUBROGATION IS WANED, subject to the terns and Conditions of the poUcy, certain policies may require on endorsement A statement on <br />this Certificate does not confer rights to the certificate holder In lieu of such ondomament e , <br />PRODUCER - <br />ME: Certificate Issuance Team <br />Comprehensive Insurance Samicee <br />rAHME . (949) 7'OM8D0� (949) 709.1886 <br />26429 Rancho Parkway Sough <br />ADDRESS: )eremyWocompreheneWnsurance.com <br />Suite 120' . . <br />INSURER(0)AFFORDINOCOVERAOE <br />xuce <br />Lake Forest CA 92630 <br />INSURERA: No ProUbinsumna Alllenoeof Califomis <br />10023 <br />INSURED <br />mSURER a; Slate Compensation tnammm Fund <br />3SOT6 <br />Orange County Fair Housing <br />INSURERC: <br />2021 E. 4th St. Ste. 118 & 122 <br />INSURER D r <br />WSURERE: <br />Santa Ane CA 927D5 <br />INsuRER F; <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PEROD <br />INDICATED, NOTWITHSTANDINOANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENTWITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE ISSUED CR MAY PERTAIN, THE INSURANCEAFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />01811 LTR <br />TYPEDPiNeuB ce <br />INSD <br />PGUCYNLtUNR <br />PIRACY up <br />LIMITS <br />COMMSRCIALGENERALUAa1l7rY <br />CLA1L16+L1ADE ® OCCUR <br />EACH OCCURRENCES <br />1,000,000 <br />PaEM 8 Ea <br />i 600,000 <br />HIED ENPlMvone <br />S 20,000 <br />A <br />Y <br />2022-03733 <br />07/01I2022 <br />0710112023 <br />PERSONA. SADV INJURY <br />i 1.000,000 <br />GEMLAGGREGATE UMITVK(Ea PER: <br />POLICY p JECaT ® LOG <br />CENERALAGGREGATE <br />S 3,WO,000 <br />PRODUCTS-COMPIOPAGG <br />$ 31000,000 <br />$ <br />OTHER: <br />AUTOMOBILE <br />UANUTY <br />M EO. IN LEU <br />f i,000,000 <br />BODILY INJURY (PW w"I <br />i <br />ANYAUTO <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />IRED No <br />HED <br />ONLY AUTOSSOONLY <br />2022-03733 <br />07/0112022 <br />07191/2023 <br />EMILY INJURY 1PM atdmmi <br />I <br />i <br />UMBRELUUAB <br />OCCUR <br />EACH OCCURRENCE <br />S 1,000,000 <br />AOGREWTB <br />y 1,000,000 <br />A <br />eXCEBa uA9 <br />CLAMS-NADE <br />2022-03733-UMB. <br />07/01/2022 <br />07/0112023 <br />DIED RETENTION i 10000 <br />S <br />B <br />WORMERSCOMPENa1T10N <br />ANDIMIKOVERa'LINNUTY <br />Af/PROPRIETORR'ARTNER�CUNVE YIN <br />OFFICE RIMEMBERExCLUDED9 M <br />(Mend=WY In NHl <br />Iyea,d orbeunder <br />DESCRIPTION OF OPERATIONS bell" <br />NIA <br />' <br />9D99740-22 <br />0611612022 <br />OSf1612023 <br />b�TATUIE <br />E.L EACH ACCIDENT <br />i 1,000,000 <br />E.L. DISEASE -EA EMPLOYEE <br />S 1,0D0.000 <br />EL mSEASE-POLICY LIMIT <br />i 1,000,000 <br />A <br />Improper Sexual Conduct Liability <br />2022-03733 <br />07/01/2022 <br />0710112D23 <br />$1,000,000 Aggregato <br />$1,000,000 Occurrence <br />U30FUPTION OF OMRATONSI LOCATIONS I VENCLES IACORD 101. AddMosal RomMb 110"lA may bo attadrd 0 man apace h rpulrm# <br />The City of Santa Ana, Its officers, employees, agents, volunteers and representatNes are Included as Addftlanal Insured per attached endorsement NIAC <br />E61. This Insurance Is Primary and Non-Contnbulory per endorsement NIAC E61. 30 day notice of canceliallon with 10 day notice or cancellation for <br />non-payment of premium per policy proNslon. <br />City of Santa Ana <br />Risk Management Dlvlson <br />20 Civic Center Plaza <br />Santa Ana <br />CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF NOTICE WILL BE DBUVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />by 1960.2015 ACORD COWI <br />ACORD 25 (2016103) The ACORD nemo and logo are registered marks of ACORD a �& Nv <br />F 11 Ir 7W tpicwdrt <br />