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An 1e ' Digitally signed
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />by nf�d@IMM/oonr
<br />A r Ar Tort A30212022
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UQlIME F'I� R. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED F. a TH�N.._ ir'.!FS
<br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURFh(Sy,"! l" 1.� ;��
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT. If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURE r'provistontti
<br />r
<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 Ilau of such andorsemantfel.
<br />PRODUCER
<br />NAME:
<br />Cartif ea is Issuance Team
<br />Comprehensive Insurance Services
<br />ONN
<br />(gqg) 709-8800 A�
<br />(949) 709-1688
<br />26429 Rancho
<br />Parkway South
<br />A
<br />pooaEd
<br />E
<br />In
<br />Ba
<br />jaremy@thecomprehensivelnsumnce.com
<br />Suite 120
<br />INSURER(S) AFFORDING COVERAGE
<br />NAICN
<br />Lake Forest
<br />CA 92830
<br />INSURERA:
<br />Nonprofits Insurance Alliance of California
<br />10023
<br />INSURED
<br />INSURERS:
<br />StarNet Insurance Company
<br />40045
<br />Delhi Center
<br />INSURERC:
<br />505 E. Central Ave.
<br />Santa Ana CA 92707 1 INSURER F•
<br />COVERAGES CERTIFICATE NUMBER: CL2111205495 REUM!0N slUM21E
<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 ALLTHE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />NSR
<br />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />WVD
<br />POLICYNUMSER
<br />MMrOI DIYYI%
<br />MMIDOnVYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />—XI
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMSMADE I OCCUR
<br />PREMISES Ea coca ends
<br />$ 500,000
<br />MED EXP (Any one porsan
<br />$ 20,000
<br />PERSONAL &ADV INJURY
<br />$ 11000,000
<br />A
<br />Y
<br />2021-01376
<br />11/01/2021
<br />11/01/2022
<br />UNITAPPLIES PER
<br />GENERA -AGGREGATE
<br />$ 3,000,000
<br />GENI.AGGREGATE
<br />PRODUCTS.COMP/OPAGG
<br />§ 3,000,000
<br />POLICY ❑'n FX LOC
<br />OTHER:
<br />$0 Deductible
<br />$
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Eaaccidenl
<br />$ 11000,000
<br />ANYAUTO
<br />BODILY INJURY (Per person)
<br />$
<br />A
<br />OWNEDONLY SAUTOCHESDULED
<br />AUTOS
<br />2021-01376
<br />11/01/2021
<br />1U01/2022
<br />BODILY INJURY Per weldent)
<br />$
<br />!g
<br />HIRED
<br />AUrOSONLY
<br />PROPERTYD AGE
<br />AUTOS ONLY I
<br />$0 Deductible
<br />$
<br />x
<br />UMSRELLAUAB
<br />X1
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 11000,000
<br />A
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />2021-01376
<br />03/0212022
<br />11/01/2022
<br />AGGREGATE
<br />$ 11000,000
<br />DED
<br />RETENTION $
<br />$
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />-
<br />PER
<br />X ERH
<br />$0 DedUCUb1e
<br />B
<br />YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE ❑N
<br />OFFICERIMEMBER EXCLUDED?
<br />NIA
<br />BNUWC0152622
<br />11/01/2021
<br />11l01/2022
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />(Mandatory In NH)
<br />f9es, describe under
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />C.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />Social SeVice.Professlonal Liability
<br />$3,0001000/1,000,000
<br />Aggregate/Occurr.
<br />A
<br />Improper Sexual Conduct Llab111ty
<br />2021-01376
<br />11/0112021
<br />11/01/2022
<br />$1,000,00011,000,000
<br />Aggregate/Occurr.
<br />$0 Deductible
<br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be aaached If more space Is required)
<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 per attached endorsement CG2026. Such Insurance as is afforded by this policy shall be primary, and any Insurance carded
<br />by City shall be excess and noncontrlbutory per attached endorsement NIAC E61. 30 day notice of cancellation with 10 day notice of cancellation for
<br />nonpayment of premium per policy provision. Umbrella policy applies over and above General Llablllty coverage.
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza
<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 />@ 1988.20'
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks ofACORD
<br />,. �, XIaFMRnegemattDlpleim
<br />- REVIEWED&APPROVFDBY.
<br />8 iz
<br />t= L AdIp F'(f aL'ek
<br />Risk Mamge.ment Spcdalist
<br />
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