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AGENCY CUSTOMER ID: INTEHOU-03 <br /> _ LOC#: <br /> A ® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br /> AGENCY NAMED INSURED <br /> Arthur J.Gallagher Risk Management Services,LLC Interval House <br /> P.O.Box 3356 <br /> POLICY NUMBER Seal Beach,CA 90740 <br /> CARRIER NAIC CODE <br /> EFFECTIVE DATE: <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br /> Computer Fraud: Limit:$2,000,000/Deductible:$15,000 <br /> Fund transfer fraud:Limit:$2,000,000 I Deductible:$15,000 <br /> Money Orders and counterfeit paper currency:Limit: :$2,000,000/Deductible:$15,000 <br /> Policy:Abuse or Molestation Liability <br /> Policy#:HHS 8525626-17 <br /> Carrier:Berkley Regional Insurance Company <br /> Policy Term: 10/1/2023 To 10/1/2024 <br /> Per Claim:$1,000,000/Aggregate:$3,000,000 <br /> Policy:Professional Liability <br /> Policy#:HHS 8525626-17 <br /> Carrier:Berkley Regional Insurance Company <br /> Policy Term:10/1/2023 To 10/1/2024 <br /> Per Claim:$1,000,000/Aggregate:$3,000,000 <br /> Policy:Commercial Property <br /> Policy#:HHS 8525626-17 <br /> Carrier:Berkley Regional Insurance Company <br /> Policy Term:10/1/2023 To 10/1/2024 <br /> Blanket Building:Limit:$6,465,315/Deductible$1,000 <br /> Blanket Business Personal Property:Limit:$931,540/Deductible$1,000 <br /> Policy:Directors&Officers Liability <br /> Policy#:PHSD1828308 <br /> Carrier:Philadelphia Indemnity Insurance Company <br /> Policy Term:10/1/2023 To 10/1/2024 <br /> Per Claim:$1,000,000/Aggregate:$1,000,000/Retention:$5,000 <br /> Re:Contract#A-2023-083-02 City of Santa Ana,its officers,agents,employees and volunteers are named additional insured with respect to the General Liability <br /> policy of the named insured.The insurance provided in the General Liability and Network Security and Privacy Liability policy is primary and any other insurance <br /> shall be excess only,and not contributing. Waiver of Subrogation for Workers Compensation policy applies in favor of Additional insured. Such insurance is <br /> Primary and Non-Contributory.Written notice shall be provided at least ten(10)days in advance of cancellation for non-payment of premium and thirty(30)days <br /> in advance for any other cancellation or policy change. <br /> / <br /> g o�.w f Risk MsnsgementDtvisian <br /> a;�� REVIEWED&APPROVED 8Y: <br /> � 111a)" A..,�,,e�d,:,�z Aaevul. <br /> ®. Risk Management Specialist <br /> ACORD 101 (2008/01) ©2008 ACORD i/ <br /> The ACORD name and logo are registered marks of ACORD <br />