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Dg w" YOnetl t'Tat P,e " <br />Tori Pierson Dais M2207.191204.H <br />ACORiff CERTIFICATE OF LIABILITY INSURANCE <br />`� <br />DATE(MWDDIYYYY) <br />711312022 <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 endoreement(s). <br />PRODUCER <br />Arthur J. Gallagher B Co. <br />Insurance Brokers of CA, Inc. <br />505 N Brand Blvd, Suite 600 <br />Glendale CA 91203 <br />czTeCT Star Met ry <br />PHC E 818.539.6623 FAX � 818.539.8723 <br />EJAAILEIJI <br />A Star Metry0aig.mm <br />INSURERS) AFFORDING COVERAGE <br />NAIC0 <br />INSURER A: Insurance Company of the West <br />27847 <br />INSURED COMMACT@0 <br />Community Action Partnership of Orange County <br />11870 Monarch Street <br />INsum B: Non rofits' InsuranceAllianceof CA <br />10023 <br />INSURER C <br />INsaaER o <br />Garden Grove CA 92841 <br />INSURER E <br />INSURERF: <br />CERTIFICATE NUMBER - <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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE 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 />MISR <br />TYPE OF HSURANCE <br />ADD <br />9 B <br />POLICY NUMBER <br />I"pFF pY E <br />POLN:YEXP <br />DMRf <br />8 <br />X <br />COMMERCMLGENERALUAeIL1TY <br />Y <br />Y <br />2022-OG441 <br />7/V2022 <br />V1/2023 <br />EACH OCCURRENCE <br />$1.000.000 <br />PREMISES <br />55GO,D00 <br />CLAIM&MADE r—xl OCCUR <br />MEO EXP lAr, are emearij <br />f 20,000 <br />PERSONAL L ADV INJURY <br />51,000,000 <br />AGGREGATE LWm APPLIES PER: <br />POLICY E JPEHgT FX-1 LOC <br />GENERALAGGREGATE <br />f2.000.000 <br />GENT <br />PRODUCTS-COMP/OPAGG <br />S2,000,000 <br />5 <br />OTHER: <br />8 <br />AUTOMONILEUABILITY <br />2022-00441 <br />7/1/2G22 <br />7/t12023 <br />CONSINEDSINGLEUMIT <br />(Ea vooderfil <br />51,000.000 <br />X <br />ANY AUTO <br />BODILY INJURY (Par pxacn) <br />5 <br />CW o sCNE0ULE0 <br />AUTOS ONLY AUTOS <br />BOOZY INJURY Tv acTJExe) <br />f <br />HIREDX AUTOS ONLY X AUTOS ONLYPROPElder <br />ki OE <br />S <br />S <br />B <br />X <br />UVSNELA uA9 <br />X <br />OCCUR <br />2022-00441-UMa <br />7/12022 <br />7112023 <br />EACH OCCURRENCE <br />35.000.000 <br />AGGREGATE <br />S5.0OQ000 <br />EXCESS LIAR <br />CLAHL9JuAlie <br />DIED I X I RETEMIONS <br />5 <br />A <br />YrORKERSCOMPENSATgN <br />AND EMPLOYERS' WBLRT YIN <br />ANYPROPRIETORIPARTNENIEXECUTIVE <br />OFFICERIMEMBEREXCLUDEDT ❑ <br />NIA <br />VWE 505610702 <br />7112D22 <br />7112023 <br />X <br />E.L. EACH ACCIDENT <br />$1.000.000 <br />EL DISEASE -FA EMPL <br />f1,000.000 <br />(YanEats, In NN) <br />USO=MN urger <br />DESCRIPTION OF OPERATIONa hebr <br />EL DISEASE -POLICY UNIT <br />51 D00,000 <br />B <br />Daetlws Olficxs <br />20224W441-0O <br />7112022 <br />7112023 <br />Ea WmngU Ad <br />$1,000.000 <br />Agyeprle Lxre <br />f2,000.000 <br />RefenSm <br />$5.000 <br />DESCRIPTION GF OPERARONS I LMATONS 1 VEHICLES (ACORD 101, Adelliunal Remarks Sch"UN, maY be aPacNea H more apau Is rpulra4) <br />Nonprofits' Insurance Alliance of CA - A.M. Best A: 011845 <br />Policy: Improper Sexual Conduct <br />PalicyY: 2022-00441 <br />Policy term: 71112022 to 711/2023 <br />rder CaNonprofits' Insurance Alliance of CA <br />Per Claim: $1,000.000. Aggregate Limit: $2.000,000 <br />See Attached... <br />City of Santa Ana <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 THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORQED REP ``ESENTATIVE alai flOa(arov4 dgrim <br />t,l� J Atv4M®LAragO-11". <br />1`� Si� %u f�%r�LJen <br />n 1988-2015 ACORD C(.rtekM.,.amxuOmMIAUe <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ' v <br />