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AFRO® CERTIFICATE OF LIABILITY INSURANCE
<br />DA05/1520214YY)
<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 Carfificate Issuance Team
<br />NAME:
<br />Comprehensive Insurance Services P 1 0 ' Ax No:
<br />26429 Rancho Parkway South Angie a�Ess )•r t o e.cem
<br />Suite 120 I , (sFo c vg xacs
<br />Lake Forest CA 92630 v A 10023
<br />wsuaao
<br />Ix , Re. State Com ensation InsuranceFuntl
<br />35076
<br />Orange County Childr//�g��`ss Therapeutic Aris Center
<br />IN
<br />u
<br />2215 N. Broadway /\ c e v e
<br />^`
<br />R D
<br />INSURER::,
<br />INS RE P:
<br />Santa Ana CA J27.6
<br />INSURERF:
<br />COVERAGES CERTIFICATE NUMBER- Al RFVIRInM MinuctrD.
<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 15 SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />AVOL
<br />INSD
<br />SUER
<br />MD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDD/YYYYI
<br />POUCYEXP
<br />MMMR
<br />LIMITS
<br />COMMERCIAL GENERAL UABIUW
<br />CLAIM&MADE OCCUR
<br />EACH OCCURRENCE
<br />S 1,000,000
<br />PREMISES(Eaoccunenca)
<br />S 500,000
<br />MED EXP(A one arson)
<br />S 20,000
<br />PERSONAL B ADV INJURY
<br />S 1,000,000
<br />A
<br />Y
<br />Y
<br />2023-09201
<br />1212MO23
<br />12/21/2024
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY jCaT © LOC
<br />GENERA -AGGREGATE
<br />S 3,000,000
<br />PRODUCTS -COMPIOPAGG
<br />S 3.000,000
<br />OTHER:
<br />$0 Deductible
<br />E
<br />AUTOMOBILE
<br />UABIUTY
<br />COMBINED SINGLE LIMIT
<br />Eaixxtd nt
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANYAUTO
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />2023.09201
<br />12/21/2023
<br />12/21/2024
<br />BODILY INJURY(Peraccident)
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTYDAMAGE
<br />Per ecUdenl
<br />$
<br />$0 Deductible
<br />$
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />A
<br />EXCESS LIAR
<br />culMsrnAOE
<br />2023-09201
<br />12/21/2023
<br />12/21/2024
<br />DED RETENTIONS
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR/PARTNEWEXECUTIVE F
<br />OFFICERRAEMBER EXCLUDED?
<br />(Mandatory In NH)
<br />DESCRIPTION OF OPERATIONS below
<br />DESCRIPTOR OFF
<br />NIA
<br />9265171-24
<br />06105f2024
<br />06/05/2025
<br />PER OTH.
<br />STATUTE ER
<br />$O Deductible
<br />EL EACH ACCmENT
<br />S 1,000,000
<br />E.L. DISEASE -EA EMPLOYEE
<br />E 1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />Social Service Professional Liability
<br />Improper Sexual Conduct Liability
<br />2023-09201
<br />12/21/2023
<br />12/21/2024
<br />$1,000,000/1,000,000
<br />$3.000,00011,000,000
<br />Aggregate/OCCUrr
<br />A re ate/Occurs
<br />gg g
<br />$0 Deductible
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be aeaohed if more span 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 Win 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 fortes 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, N-0 R tam I RR nFr IVFRFn IM
<br />ACCORDANCE WITH THE POLICY PRO'
<br />©1988-2015 ACOF
<br />RiskMUW8oKudDvIsian
<br />_� REVIEWED & APPROVED By:
<br />-.
<br />�ry � Ada Auwllo
<br />Risk Management Spedali4
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
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