VIETNAMESE LANGUAGE ACCESS/ASSISTANCE (VIETLA)

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Digitally signed ® '`�� CERTIFICATE OF LIABILITY I 090CE] DATE (MMIDDIYYYY) ��Ar'eswQngTYig �R��j06/01/2073 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS �PDISL �AiPOR9eFL�B"f BE CI HIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALT BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE !S;UING IN§;QW.gt9i),WWRIZED 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 Arc 23 Insurance Services 24000 Alicia Parkway #17332 Mission Viejo CA 9269t CONTACT NAME: Aaron Rosen ONE aD No Est: (949) 484-7500 IN" No): ADDRESS: aaron@uc23insurance.com INSURERIS) AFFORDING COVERAGE NAIC# INSURER A: Stillwater Insurance Svcs, Inc 25180 INSURED VIETNAMESE LANGUAGE ACCESS/AS 1056 CABRILLO PARK DR SANTA ANA CA 92701 INSURER B : INSURER C: INSURER D: INSURER E 1 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE 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. INSK LTR TYPE OF INSURANCE INSO WVO POLICY NUMBER (M,R"RYYYy) MMIDO/YYYY LIMITS x COMMERCIAL GENERAL LIABILITY RRENCE S 1,000,000 CLAIMS -MADE ERIOCCUR a occurrence) 9 IOQ000 y one person) $ IQ000 ADV INJURY MGA S 1,000,000 A Y Y BP2002951 09/28/2022 09/28/2023 GENT AGGREGATE LIMIT APPLIES PER'. GREGATE $ 2.000.000 POLICY �JECT �LOU COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY Ed) $ BODILY I NJ URY(Per person) S 1,000,000 ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y Y Bp2002952 09/28/2022 09/28/2023 BODILY INJURY(Peraccidenp S 2,000,000 HIRED V NON -OWNED AUTOS ONLY /� AUTOS ONLY r� (Per accident $ 1,000,000 S UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS -MADE AGGREGATE $ ICED I I RETENTION$ $ ORKERS COMPENSATION EMPLOYERS' LIABILITY Y/N - 1PERND STATUTE ER E.L. EACH ACCIDENT $ NY PROPRIE OR/PARTNERIEXECUTIVE OFFICEWMEMBER EXCLUDED? ElN I A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) I,, descdbe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana. its officers, officials, employees and volunteers must be covered as additional insureds on the CGL policy with respect to liability arising on[ of work or operations performed by or on behalf ofthe contractor including materials, parts or equipment furnished in connection with such work or operations. General liability coverage can be provided in the form of an endorsement to the vendor/contractor insurance. City of Santa Ana is named as additional insureds per form SB 04 36 01 17 or equivalent. City of Santa Ana Risk Management Division 20 Civic Center Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED Avraw Ro-yev ©1988.2015 ACOR ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Risk Maugement Division .19 �° REVIEWEOSAPPROV®BY: ,, A*f, AdwuCd '. ® Risk Llanagement spe,JAW