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77/31/2024
<br /> (MM/DD/YYYY)
<br /> A` �� CERTIFICATE OF LIABILITY INSURANCE
<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 CONTACT
<br /> NAME: Nick Grover
<br /> Arthur J. Gallagher Risk Management Services, LLC PHONE FAX
<br /> 500 N. Brand Boulevard A/C No EXt: 818-539-1336 A/c,No:818-539-1636
<br /> E-MAIL
<br /> Suite 100 A . ADDREs:: nick_grover@ajg.com
<br /> Glendale CA 91203 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER. United Educators Ins,a Reciprocal Risk Retention 10020
<br /> INSURED UNVLAVE-01 t ( Iny n e 25674
<br /> University of La Verne INSURER! T I Ic
<br /> 1950 Third Street INSUREP Acevedo
<br /> La Verne, CA 91650 INSUR, c D:
<br /> INSU' ERE ^� 1
<br /> 00
<br /> A leN If tw% Atw% INF�,:,r �, ate . .
<br /> COVERAGES CERTI A NU E 1 54 852_ REVISION NUMBER:
<br /> THIS IS TO CERTI THA H OLI OF—INSUMME=TrzD B_=0W HA` E BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDI',10', 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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR I POLICY NUMBER MM/DD/YYYY MM/DDIYYYY
<br /> A X COMMERCIAL GENERAL LIABILITY U06-360 8/1/2024 7/1/2025 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED
<br /> PREMISES Ea occurrence $1,000,000
<br /> X $10,000 Ded. MED EXP(Any one person) $5,000
<br /> PERSONAL&ADV INJURY $Included
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000
<br /> POLICY PRO LOC PRODUCTS-COMP/OP AGG $Included
<br /> X JECT
<br /> OTHER:El $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
<br /> Ea accident
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> UMBRELLALIAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br /> DED RETENTION$ $
<br /> B WORKERS COMPENSATION UB-1S903424-24-14-G 7/1/2024 7/1/2025 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> ❑
<br /> OFFICER/MEMBER EXCLUDED? NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> A Professional Liability U06-360 8/1/2024 7/1/2025 Each Claim 1,000,000
<br /> (Claims Made) Aggregate 3,000,000
<br /> Deductible 10,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Subject to all policy terms,conditions,and exclusions.
<br /> City of Santa Ana,officers,agents,employees,and volunteers are named are additional insureds for general liability coverage as required by virtue of a written
<br /> contract or agreement and to the extent insurable as respects their interest in the operations of the named insured.The insurance provided by this policy is
<br /> primary,and all other insurance available to the additional insured is non-contributory.Waiver of Subrogation applies in favor of the Certificate Holder for
<br /> General Liability and Workers Compensation if required by virtue of a written contract or agreement.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF. NOTICE WILL RI= DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PRC
<br /> Risk Management Division „oR RUManaganentDivisum
<br /> 20 Civic Center Plaza, 4th Floor s -'G` IFpE
<br /> Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE a, VIEWED br P>PPROVm BY:
<br /> USA � � ' A A�evo
<br /> ®' Risk Management Specialist
<br /> @ 1988-2015 ACORD
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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