LUTHERAN SOCIAL SERVICES OF SOUTHERN CALIFORNIA (7)

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AC" CERTIFICATE OF LIABILITY INSURANCE DATF(MMIDDIYYYY) lll✓ 1 02/1312025 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 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),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. 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 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). PRODUCER CONTACT Michael Wakely NAME: Commercial Management Insurance Services Inc. a1c No Ext: {714}406-1687 FAX,tAIC No: (714)414-1195 CA License OD85858 E-MAIL mwakely@cmis-ins.com ADDRESS: 751 S Weir Canyon Rd,157-355 INSURER(S)AFFORDING COVERAGE NAIC A Anaheim CA 92808 INSURER A: Redwood Fire&Casualty Insurance 11673 INSURED INSURER B: Lutheran Social Services Southern California INSURER C: 999 W.Town and Country Rd. INSURER D: Suite 100 INSURER E: Orange CA 92868 INSURER F', COVERAGES CERTIFICATE NUMBER; 25-26 MASTER REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WSR AUULbUUK POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY MMIDDNYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S NFED CLAIMS-MADE ❑ OCCUR DAMAGE I RE PREMISES Ea occurrence 5 MFD EXP(Any one person) S PERSONAL&ADV INJURY S G EN'L AGGREGATE LI MIT APPLIES PER: GENERAL AGGREGATE S POLICY 0 PROJECT LOC PRODUCTS-COMPIOP AGG S OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S Ea accident ANYAUTO BODILY INJURY{Per person) 5 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per acnidenq 5 HIRED NOW-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY Per accident S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S ❑ED RETENTION$ S WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY ANY PRO PRIETORIPARTNERIEXECUTIVE Y f N E.L.EACH ACCIDENT S 1,000,000 A OFFICERIMEMBEREXCLUDED? NIA Y LUWC626050 01/O112U25 01101l2026 (Mandatory in NH F.L.DISEASE-EA EMPLOYEE $ 1,000,00D If yes,describe under 1,000,DOD DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required( WAIVER OF SUBROGATION APPLIES IN RESPECTS TO WORKERS COMPENSATION PER ATTACHED WC 99 04 10 C Tu TrB n e r�Tr- °, APPROVED .an �°guyen Nguyen By Tu Tran Nguyen at 2:10 pm, Feb 13, 2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN CITY OF SANTAANA-COMMUNITY DEVELOPMENT ACCORDANCE WITH THE POLICY PROVISIONS. AGENCY AUTHORIZED REPRESENTATIVE 20 CIVIC CENTER PLAZA,M-25 SANTAANA CA 92701 � ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD