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AC©R" CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIDDIYYYY)
<br />1
<br />llkh.�
<br />06/16/2025
<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 INSUREII 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
<br />CONTACT Certificate Issuance Team
<br />NAME:
<br />Comprehensive Insurance Services
<br />PAHfONN (949) 709-8800 A
<br />Ext . C, No
<br />26429 Rancho Parkway South
<br />E-MAIL jeremy Q@thecomprehensiveinSUrance.com
<br />ADDRESS:
<br />Suite 120
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC N
<br />Lake Forest CA 92630
<br />INSURER A: Nonprofits Insurance Alliance of California
<br />10023
<br />INSURED
<br />INSURER B : State Compensation Insurance Fund
<br />35076
<br />Orange County Children's Therapeutic Arts Center
<br />INSURER C :
<br />2215 N, Broadway
<br />INSURER D :
<br />INSURER E
<br />Santa Ana CA 92708
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: All REVISION NUI I
<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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE 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 />INSD
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYYY
<br />POLICY EXP
<br />[MMIDD/YYYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE OCCUR
<br />RENTED
<br />PREMISES Ea occurrence
<br />$ 500,000
<br />ME EXP (Any one person)
<br />$ 20.000
<br />PERSCNAL & ADV INJURY
<br />$ 1.000.000
<br />A
<br />Y
<br />Y
<br />2024-09201
<br />12/2112024
<br />12/2112025
<br />GEN'LAGGREGATELIMITAPPLIESPER:
<br />I GENERAL AGGREGATE
<br />$ 3,000,000
<br />ECT POLICY ❑ PRO ® LOC
<br />PRODUCTS - COMPIDPAGG
<br />$ 3.000.000
<br />$0 Deductible
<br />OTHER:
<br />AUTOMOBILE
<br />LIA81LITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />Y
<br />Y
<br />2024-09201
<br />12/2112024
<br />1212112025
<br />BODILY INJURY( Per accident)
<br />5
<br />X
<br />HIRED �/ NON -OWNED
<br />X
<br />PROPERTY DAMAGE
<br />$
<br />AUTOS ONLY AUTOS ONLY
<br />Per accident
<br />$0 Deductible
<br />$
<br />X
<br />UMBRELLA LIAR
<br />x
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 1,0o0,000
<br />A
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />2024-09201-UMB
<br />12/21/2024
<br />12/2112025
<br />AGGREGATE
<br />$ 1,000,000
<br />DED RETENTION $ 10000
<br />$
<br />WORKERS COMPENSATION
<br />ORH
<br />X
<br />$0 Deductible
<br />AND EMPLOYERS' LIABTLITY YIN
<br />STATUTE
<br />E.L. EACH ACCID ENT
<br />$ 1,000,000
<br />B
<br />ANY PRO PRIETORfPARTNERfEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED?
<br />NIA
<br />Y
<br />9255171-25
<br />06105/2025
<br />06/0512026
<br />E.L DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />$ 1,000,000/1,000.000
<br />AggregatelOccurr
<br />Social Service Professional Liability
<br />A
<br />Improper Sexual Conduct Liability
<br />2024-09201
<br />12/21/2024
<br />12/21/2025
<br />$3,000.000/1,000.000
<br />AggregatelOccurr
<br />$0 Deductible
<br />DESCRIPTION OF OPERATIONS I 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 included as Additional Insured per attached endorsement CG2026 & NIAC E131 &
<br />NIAC Al. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by
<br />this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of The City of Santa Ana, Its officers,
<br />officials, employees, and volunteers per attached endorsement NIAC El 30 day notice of cancellation with 10 day notice of cancellation for non-payment
<br />of premium per policy provision. See attached forms list. Waiver of Subrogation applies per attached endorsement NIAC E26, CA 0444 & 10217. 30 day
<br />notice of cancellation with 10 day notice of cancellation for non-payment of premium per policy provision,
<br />n'igilany sgned
<br />Tu Tf a n N�Ye ran
<br />APPROVED
<br />I=rrCERTIFICATE q
<br />HOLDER CANCELL.ATIO 1q 14-' , By Tu Tran Nguyen at 3:38 pm, Jul 03, 20:
<br />_
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana - Attn: Executive Director
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Community Development Agency
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza, M-25
<br />Santa Ana CA 92701�:.
<br />c01988.2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />,J
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