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ACC)RL>® DATE(MM/DD/YYYY)
<br /> `� CERTIFICATE OF LIABILITY INSURANCE 0 611 1/2 0 24
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY
<br /> AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),
<br /> AUTHORIZED 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.If SUBROGATION IS WAIVED,subject to the terms and
<br /> conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT
<br /> CIA • • •
<br /> Brian Case(9715360) 4.
<br /> PH
<br /> 3607 S El Camino ReAn-q-ie
<br /> A/C,NO,E 49-716-364 A/C,NO):949-498-7817
<br /> E-M IL •
<br /> San Clemente AD- Ic .com
<br /> INSURE AFFORDING COVERAGE NAIL#
<br /> INSURED knof , su RA: Truck Insuran Exchange 21709
<br /> INS r e xchange 21652
<br /> KOMPASHION INC
<br /> 33 ESTERO POINTE INsuR, c: Mid Century Insurance Company 21687
<br /> eved —
<br /> •
<br /> NS � • •
<br /> ALISO VIEJO Ac
<br /> ---
<br /> INSURER F:
<br /> COVERAGES CERTIFICATENI''nBEP • • RE SI N E
<br /> UO
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HA'E R'-A ISSUED TOTH E INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY
<br /> REQUIREMENT,TERM OR CONDITION OFANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE
<br /> POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHETERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR TYPEOFINSURANCE ADDTL SUBR POLICYNUMBER POLICY Err POLICY EXP LIMITS
<br /> LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY)
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> DAMAGE TO RENTED
<br /> CLAIMS-MADE N
<br /> OCCUR PREMISES(Ea Occurrence) $ 75,000
<br /> X Professional Liability MED EXP(Any one person) $ 5,00
<br /> B Y Y 607081680 06/10/2024 06/10/2025 PERSONAL&ADV INJURY $ 2,000,000
<br /> GEN'L AGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 4,000,000
<br /> X POLICY ❑ PROJECT ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
<br /> (Fa accident)
<br /> ANYAUTO BODILY INJURY(Per person) $
<br /> B OWNEDAUTOS SACOEDULED BODILY INJURY(Per accident)$
<br /> Y Y 607081680 06/10/2024 06/10/2025
<br /> HIRED AUTOS X NON-OWNED PROPERTY DAMAGE
<br /> X ONLY AUTOSONLY (Per accident) $
<br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $
<br /> DED I RETENTION$ $
<br /> WORKERS COMPENSATION PER OTHER $
<br /> AND EMPLOYERS'LIABILITY STATUTE
<br /> ANY PROPRIETOR/PARTNER/ Y/N E.L.EACH ACCIDENT $ 1,000,000
<br /> N/A
<br /> EXECUTIVE OFFICER/MEMBER A09521216 06/10/2024 06/10/2025
<br /> B EXCLUDED?(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE 1 1,000,000
<br /> Ifyes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> The Santa Ana City,its officers,officials,employees,and volunteers are covered as additional insureds. This insurance coverage shall be primary coverage at
<br /> least as broad as ISO CIS 20 01 04 13 as respects the City,its officers,officials,employees,and volunteers.Any insurance or self-insurance maintained by the
<br /> City,its officers,officials,employees,or volunteers shall be excess of the Contractors insurance and shall not contribute with it.This policy grants waiver of any
<br /> right to subrogation which any insurer of said Contractor may acquire against the City by virtue of the payment of any loss under such insurance
<br /> CERTIFICATE HOLDER CANCELLATION R1AMnnaganedDMs1c% "
<br /> Clerk of the City Council,City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLI, ?% REVIEwED&APPROVEDBY:
<br /> 20 Civic Center Plaza(M-30) DATE THEREOF NOTICE WILL BE DELIVERED It y �1
<br /> A�Acevedo
<br /> P.O.BOX 1988 AUTORIZ€D REPR TATIVE ®' Risk Management Specialist
<br /> Santa Ana CA 92702
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION.All Rights Reserved
<br /> 31-1769 11-15 The ACORD name and logo are registered marks of ACORD
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