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AC6RH CERTIFICATE OF LIABILITY INSURANCE <br />L <br />DAM(MMIDDNYYY) <br />1 <br />V <br />09/20/2024 <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 endomement(s). <br />PRODUCER <br />CONTACT Marci Davis <br />NAME: <br />Pours &Associates Insurance Brokers <br />ONEo (800) 578-8802 FAX (818) 449-9321 <br />PAIC <br />NHExt: AIC No: <br />E-MAIL ADDRESS: mdavis@pomsassoc.com <br />CA License#0814733 <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />4500 Park Granada, Suite 205 <br />INSURERA: Nonprofits Ins. Alliance of CA(NIAC) <br />160 <br />Calabasas CA 91302 <br />INSURED <br />INSURER B : <br />Working Wardrobes ForA New Start <br />INSURER C : <br />2000 E. McFadden Ave <br />INSURER D : <br />Suite 100 <br />INSURER E: <br />Santa Ana CA 92705 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 24-25 GLAU LIMB REVISION NUMBER: <br />THIS IS TO CERTIFY THATTHE 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 />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUSR <br />MD <br />POLICYNUMBER <br />POLICY EFF <br />(MMID <br />POLICY EXP <br />MMMD <br />LIMITS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE � OCCUR <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMA ET RENTED <br />PREMISES Eaoccueenos <br />500,000 <br />$ <br />MED EXP (Any one person) <br />$ 20,000 <br />PERSONALSADV INJURY <br />$ 1,000,000 <br />A <br />Y <br />Y <br />2024-49231 <br />09/17/2024 <br />09/17/2025 <br />GEN'LAGGREGATE LIMITAPPLIES PER: <br />PRO- <br />POLICY ❑ PRO ❑ <br />JECT LOC <br />GENERALAGGREGATE <br />$ 2,000,000 <br />PRODUCTS-COMP/OPAGG <br />2,000,000 <br />$ <br />Liquor Liability - Common <br />$ 1,000,000 <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />GBMBbNED SINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />X <br />BODILY INJURY (Per person) <br />$ <br />ANYAUTO <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />Y <br />Y <br />2024-49231 <br />09/17/2024 <br />09/17/2025 <br />BODILY INJURY (Par accident) <br />$ <br />X <br />HIRED XNDN-OWNED <br />AUTOS ONLY AUTOSONLY <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />Uninsured Motorist <br />$ 1,000,000 <br />X <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ 2,000,000 <br />AGGREGATE <br />$ 2,000,000 <br />A <br />EXCESS LIAB <br />CLAIMSMADE <br />2024-49231-UMB <br />09/17/2024 <br />09/17/2025 <br />DED RETENTION $ <br />$ <br />L <br />WORIUMSCOMPENSATION <br />AND EMPLOYERVLIABILITY YIN <br />ANY PROPRIETORIPARTNERIEXECUTIVE E]NIA <br />OFFICER/MEMBER EXCLUDED? <br />PER OTH- <br />sTATUTE ER <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE -EA EMPLOYEE <br />$ <br />(Mandatory in NH) <br />If yes, describe under <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS below <br />A <br />Improper Sexual Conduct &Physical <br />Abuse <br />202449231 <br />09/17/2024 <br />09/17/2025 <br />General Aggregate <br />Each Claim Limit <br />$2,000,000 <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I 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 to be covered as additional insureds on the CGL policy with respect to liability <br />arising out of work or operations performed by or on behalf of the Contractor including materials, parts, or equipment furnished in connection with such work <br />or operations. Such Insurance as is afforded by this policy shall be primary, and any insurance Tarried by City shall be excess and noncontributory. Waiver <br />of Subrogation applies per the attached forms. <br />30 day notice of cancellation (except for 10 day notice of cancellation for non-payment) <br />City of Santa Ana 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, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PRO) <br />AUTHORIZED REPRESENTATIVE <br />©1988-2016 ACOF <br />AEVIEwED& APPacivi�lBY. <br />`'®� <br />A+aycr Ad�wac� <br />Risk ManagementSpedast <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />