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CERTIFICATE OF LIABILITY INSURANCE
<br />DATE IMMIDDIYYYYI
<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(los) 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 endorsomeni(s).
<br />PRODUCER N Da ria Matthews
<br />Cobbs, Allen & Hell, Inc. --------- —
<br />115 Office Park Drive, Ste 200 I'VOI Nd ,t 12058743611 talc Nor. 208-414-8105
<br />Birmingham AL 35223 E-MAIL
<br />ADcaess amait-e-W @C.obhsallon.com
<br />INSURERiSLArFORDINe COVERAGE. _ HAD
<br />INSURED INTEINTgI
<br />Intercoas{ International Training, Inc.
<br />-----INSURER D
<br />National Fire IDS. p( Hartford
<br />- - - ------
<br />20478 --
<br />21840 Van Buren Blvd., Suite 1
<br />INSURER C:
<br />Security National Inc Cc
<br />33120
<br />Attn: Goals Brown
<br />INSURER o:
<br />Harco National, Insurance.. Company
<br />'., 20433
<br />Riverside CA 92508
<br />INSURER E •,
<br />Continental Insurance _... _.
<br />INSURER F:
<br />•..
<br />COVERAGES CERTIFICATE NIIMRERr 1111AT1003
<br />ac�mm�u u
<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, LIMIT'S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />.AUOLISBeIt; __... ....__. POLICY ErP---POLICYEXR
<br />LT TYPE OF INSURANCE NSDI WVDL POLICYNUMBE �(MMIDDttYYYI IM_MlpeIYYYYIY __ UNITS
<br />B
<br />jX-,COMMERCIAL G6NE�IASILITY V 7012416241 1/12/2023 311212024 EACH OCCURRENCE 31,000 ODD
<br />CLAIMS-MgDE X I OCCUR bKMPREMISES SE5
<br />sap c,u seen) . $100.000
<br />_ MED EXP (Any one person) $15,000
<br />PERSONALS ADV INJURY S1,000000
<br />4GEN'LAGGREGAI'f LIMITAP PLIES PER: GENERAL AGORf_OATE S2.000,0D0
<br />PRO. _ .. ....
<br />X POLICY vJECT ,._ LOC PRODUCTS :OMPIOP AG $2,000,000
<br />OTHER $
<br />A
<br />iAUTDMbeILE LIARILTY - 70146BB03B 3/12/2023 3/12/2024 COMBINED DI OW LIMIT gi.pUO,000
<br />Po6minl
<br />ANY AUTO BODILY INJURY One Pms,YC
<br />OWNED --- SCHEDULED --
<br />A ALTOS ONLY BODILY INJURY IPe,'arsidenB'. $
<br />(_X II 'PROPER AMAGEO
<br />L.... AUIOS ONLY a AUT OS ONLY LFs APdltitll
<br />S
<br />E
<br />iX. UMBRELLA LIAB X CCCUR CUE7014700425 3112/2023 3/1212024 EACN OCCURRENCE 45A00,000
<br />iEXCESS LIAS _ f CLAIMS -MADE S5,000,OOO
<br />„AOORFOATE __. _ _
<br />i
<br />OED-LX ft TENTION3 [)�1 g
<br />O
<br />__
<br />WORKERS COMPENSATION BWC1426131 2/10l2023 2l10f7024 X P R GTH.
<br />gAIUTF......_,
<br />ANDEMPLOYERS'LIASILTY YIN .__ CR__.... _...._..
<br />ANYPRCUMEMSEREXTUDIRD? CD I'IV0 E.L. EACIi ACCIDENT $1,000A00
<br />OFFlCEtoryt.BEREXGLUDC-DT n Nlq .. _.._
<br />NH} EL. DISEASE EA EMPLGYEE,$1.000,OOU
<br />If yea, de.In
<br />,DESCRIPTION OF OPERA BOND lrebw E 1, DISEASY:-POLICY LIMIT $ I,UDO,_000
<br />D Mana OTIAMLIMULN :PMLOWU767 4/11/2022 4/1112023 CEO SharOd UlmJ 3,000,UOn u
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101, Addllional Remarks Schenim.. may be MD.hod It more $pace Is roquimd)
<br />City of Santa Ana Workforce Training Program, City of Santa Ana, officers, agents, employees, and volunteers are named as additional insureds as respects
<br />General Liablllfty as required by written contract, agreement, or memorandum of understanding. Such insurance as is afforded by this policy shall be primary.
<br />and any insurance carried by City shall be excess and noncontributory. 30
<br />clays notice of cancellation applies par policy terms and conditions
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Risk Management Division
<br />Santa Ana CA 92702
<br />ACORD 25 (2016103)
<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 />AUTHORIZED REPRESENYATIVP.
<br />The ACORD name and logo are registered marks of ACORD
<br />All rinhla rneur.rnd
<br />
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