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-� CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DD/YYYY)
<br />05/15/2024
<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 Certificate Issuance Team
<br />NAME:
<br />Comprehensive Insurance ServiceAngie
<br />P aIc No 0 FAX
<br />(
<br />26429 Rancho Parkway South ADDRE J ) r t e o e.com
<br />Suite 120 I (S) ZFSRPNC V NAIC #
<br />Lake Forest CA 92630 ILAEYA r 10023
<br />INSURED IN ER B . State Com ensation Insurance Fund 35076
<br />Orange County Childr Therapeutic Arts Center IN u '
<br />2215 N. BroadwayAcevedc INSURER D:
<br />INS R e: •
<br />Santa Ana CA d27.6 INSURER F :
<br />rnVFROr;FS rFRTIFIrOTF NIIMRFR• All RFVISInN NIIMRFR-
<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 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 />INSR
<br />POLICY EFF
<br />POLICY EXP
<br />LTR
<br />TYPEADDILSUSR
<br />INSD
<br />WVD
<br />POLICYNUMBER
<br />MM/DD
<br />MM/DD/YYW1
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACHOCCURRENCE
<br />$ 1,000,000
<br />FX]
<br />500,000
<br />CLAIMS -MADE OCCUR
<br />PREMISES rr
<br />$
<br />MED EXP (Any one person)
<br />$ 20,000
<br />PERSONAL&ADV INJURY
<br />$ 1,000,000
<br />A
<br />Y
<br />Y
<br />2023-09201
<br />12/21/2023
<br />12/21/2024
<br />GEN'LAGGREGATE LIMITAPPLIES PER:
<br />GENERALAGGREGATE
<br />$ 3,000,000
<br />POLICY JECTPRO- F LOC
<br />PRODUCTS -COMPIOPAGG
<br />$H3,000,000
<br />$0 Deductible
<br />$
<br />OTHER:
<br />AUTOMOBILE 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 />2023-09201
<br />12/21/2023
<br />12/21/2024
<br />BODILY INJURY (Per accident)
<br />$
<br />AUTOS ONLY AUTOS
<br />PROPERTYDAMAGE
<br />$
<br />X HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />(Per accident
<br />$0 Deductible
<br />$
<br />Iq
<br />X UMBRELLA LIAB X OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />A
<br />EXCESS LIAB CLAIMS -MADE
<br />2023-09201
<br />12/21/2023
<br />12/21/2024
<br />AGGREGATE
<br />$ 1,000,000
<br />DED I I RETENTION $
<br />$
<br />WORKERS COMPENSATION
<br />X1 aRH
<br />$0 Deductible
<br />AND EMPLOYERS' LIABILITY YIN
<br />STATUTE
<br />B
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />N
<br />NIA
<br />9255171-24
<br />06/05/2024
<br />06/05/2025
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />$
<br />OFFICER/MEMBEREXCLUDED?
<br />1,000,000
<br />(Mandatory in NH)
<br />E.L. DISEASE - EA EMPLOYEE
<br />$
<br />If yes, describe under
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$
<br />$1,000,000/1,000,000 Aggregate/Occurr
<br />Social Service Professional Liability
<br />A 2023-09201 12/21/2023 12/21/2024 $3,000,000/1,000,000 A re ate/Occurr
<br />Improper Sexual Conduct Liability 99 9
<br />$0 Deductible
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 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 list. 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, NOTIrF wil I RF nFI IVFRFn Ilu
<br />ACCORDANCE WITH THE POLICY PROS
<br />AUTHORIZED REPRESENTATIVE
<br />Rlak Mvwgem&dDMsiun
<br />REVIEWED & APPROVED BY.
<br />x
<br />'`-- ----' Risk Management Specialist
<br />©1988-2015
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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