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EXHIBIT J
<br />A h!P CERTIFICATE OF LIABILITY INSURANCE
<br />?o
<br />DATE(
<br />022
<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(ies) 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 endorsement(s).
<br />PRODUCER
<br />NAME: T Certificate
<br />Issuance Team
<br />Comprehensive Insurance Services
<br />PHONE (949) 709-8800
<br />I o Exl: AIC No:
<br />26429 Rancho Parkway South
<br />E-MAIL Jeremy@thecomprehensiveinsurance.com
<br />ADDRESS:
<br />Suite 120
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC N
<br />INSURERA: Nonprofits Insurance Alliance of California
<br />10023
<br />Lake Forest CA 92630
<br />INSURED
<br />INSURERS: Stale Compensation Insurance Fund
<br />35076
<br />Orange County Children's Therapeutic Arts Center
<br />INSURER C:
<br />2215 N. Broadway
<br />INSURER D :
<br />INSURER E :
<br />Santa Ana CA 92706
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: All REVISION NUMBER:
<br />THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE 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 ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />INSLTR
<br />TYPE OF INSURANCE
<br />AVOLSUBR
<br />IN D
<br />WVO
<br />POLICY NUMBER
<br />CY EFF
<br />POLIC/YYYY
<br />EXP
<br />POLICY EXP
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />v
<br />CLAIMS -MADE X OCCUR
<br />RRENCE
<br />$ 1,000,000
<br />RENTED
<br />Eaoccurrence
<br />$ 500,000
<br />nyone person)
<br />$ 20,000
<br />PERSONAL INJURY
<br />5GENERALNAGGREGATE
<br />$ 1,000,000
<br />A
<br />Y
<br />Y
<br />2022-09201
<br />12/21/2022
<br />12/2112023
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY JECT � LOC
<br />GREGATE
<br />$ 3,000,000
<br />-COMi A"
<br />$ 3,000,000
<br />ble
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANYAUTO
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />2022-09201
<br />12/21/2022
<br />12/21/2023
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />HIRED NON -OWNED
<br />AUTOS ONLY X AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Princcldent
<br />$
<br />$0 Deductible
<br />$
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />A
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />2022-09201-UMB
<br />12/21/2022
<br />12/21/2023
<br />AGGREGATE
<br />$ 1,000,000
<br />DED
<br />RETENTION $ 10000
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIMBERE EXCLUDED?
<br />OFFICER/MEMBER EXCLUDED4
<br />(Mandatory
<br />sale andNH)
<br />Dyes, describe antler
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />9255171-22
<br />06/0512022
<br />06/05/2023
<br />v PER OTH-
<br />/� STATUTE ER
<br />$O Deductible
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />Social Service Professional Liability
<br />Improper Sexual Conduct Liability
<br />2022-09201
<br />12/2112022
<br />12/2112023
<br />$1,000,000/1,000,000
<br />$2,000,00011,000,000
<br />Aggregate/Occurr
<br />Aggregate/Occurr
<br />$0 Deductible
<br />DESCRIPTION OF OPERATIONS LOCATIONS / VEHICLES IACORD 101, Additional Remarks Schedule, may be attached If more space is required)
<br />The City of Santa Ana, Its officers, officials, employees, and volunteers are Included as Additional Insured per attached endorsement CG2026. With respect
<br />to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as Is afforded by this policy Is primary and
<br />Is not additional to or contributing with any other Insurance carried by or for the benefit of The City of Santa Ana, its officers, officials, employees, and
<br />volunteers per attached endorsement NIAC E61. 30 day notice of cancellation with 10 day notice of cancellation for non-payment of premium per policy
<br />provision. See attached forms ist. Waiver of Subrogation applies per attached endorsement NIAC E26.
<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 />©1988.2015 ACORD CORPORATION. All riehts reserved
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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