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A� o CERTIFICATE OF LIABILITY INSURANCE I DA03/2012ozn4 ) <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(8), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an AVDITIONAL INSU ED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />K rl SUBROGATION IS WAIVED, subject to tht to � j*r9f�of in pql -#e�qq/policies may require an endorsement. A statement on <br />WIBA l R Ira <br />l;t Angie Ace yu 3elfrey R Wilson <br />WIBA Insure envy, Inc. _ .,,. 949A07.9422 N01. 949266.8273 <br />25422 Trebuco Road I sS1 jeJf�wibagmup.com <br />As 1Di.s32� .. _ A _ Date: 20246 —,... ,a,.«�e�,����.�s.K — <br />United States Liability Insurance <br />PEP4U Wellness <br />32656 B Golden Lantern <br />Cana Point CA 92629 <br />COVERAGES CERTIFICATE NUMBER: REVISION 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 />INSR <br />7ypE OF INSURANCE <br />ADDLBUBR <br />POLICYNUMBER <br />POLICY SEE <br />PODCYEP <br />DMRB <br />X <br />COMMERCUILGENERALLUIBILTY <br />EACHOCCURRENCE <br />S 1.000,000 <br />CMMSMAOE �R OCCUR <br />DAMAyE To RENTED p <br />EBEMMED <br />E 100,000 <br />EXP ane <br />S 5.000 <br />PERSONALS AOV INJURY <br />S <br />A <br />X <br />NBP155526OF <br />04/182023 <br />04/18/2024 <br />GENL <br />AGGREGATE LIMIT APPLIES PER <br />GENERALAGGREGATE <br />3 2,000,000 <br />POLICY ElJJECT LOC <br />PRODUCTS-COMPIDPAGG <br />S <br />S <br />OTHER <br />AUTOMMILELIAI311.11Y <br />COMBINED SINGLE LIMIT <br />(Ea acddar t) <br />S <br />ANYAUTO <br />BODILY INJURY(PW prawn) <br />S <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per emidwq <br />_ <br />S <br />HIRED NON "ED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTYDAMAGE <br />(Per accidwtl <br />$ <br />$ <br />UMBRELMLWB <br />OCCUR <br />EACH OCCURRENCE <br />S <br />EXCESS LIAR <br />CWMSHdNDE <br />AGGREGATE <br />DELI RETENTION S <br />S <br />WORKERS COMPENSATION <br />ANDEMPLOYERS'LUIBILITY YIN <br />ANYPROPRETOWPARTNEFtfD(ECUTIVE <br />PER 0771- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />S <br />OFFICER,MEMBEREXCLUDED4 ❑ <br />NIA <br />E.L. DISEASE -EA EMPLOYEE <br />S <br />(Morid.Wry le Nlq <br />If yea thwtI sunder <br />DESCRIPTION OF OPERATIONS balmy <br />E.L. DISEASE -POLICY LIMIT <br />4 <br />A <br />Directors and Officers Liability <br />Employment Practices Liability <br />X <br />NBP1555260F <br />04/18/2023 <br />04/18/2024 <br />Per Claim D80 EPL <br />Agg E80 EPL <br />1,000,000 <br />1,000.000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, AddlSonal Ramadu Sd W ula, mW ba attached a men epee u nqulnd) <br />Those Usual To The Insureds Operations <br />All Additional Insureds are Automatic when required by written Contract <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF- Nming WILL RE nFt IVERFn IN <br />ACCORDANCE WITH THE POLICY PRC <br />M <br />RiskMaQugmiadMvulan <br />REMewEDSAFPRDV®By. <br />,,. <br />A--p Adtv44 <br />Risk Management Spectalist <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />