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DATE(MM/DD/YYYY) <br /> A�" CERTIFICATE OF LIABILITY INSURANCE <br /> 08/05/2025 <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 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 Joann Justus <br /> NAME: <br /> United Agencies ACNE. Ext: (216)696-8044 q c,No): (216)916-4871 <br /> 1422 Euclid Avenue E-MAIL ustus uainc.com <br /> ADDRESS: I) @ <br /> Suite 510 INSURER(S)AFFORDING COVERAGE NAIC# <br /> Cleveland OH 44115 INSURERA: Philadelphia Indemnity Ins Co 18058 <br /> INSURED <br /> INSURER B <br /> Lutheran Social Services of Southern California INSURER C: <br /> 999 Town and Country Road,Suite 100 INSURER D: <br /> INSURER E: <br /> Orange CA 92868 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: CL257115385 REVISION NUMBER: <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 IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE POLICY EFF POLICY EXP <br /> LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDrence $ 100'000 <br /> MED EXP(Any one person) $ 5,000 <br /> A Y Y PHPK2716952-00 07/01/2025 08/31/2026 PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 3,000,000 <br /> X POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 3'000'000 <br /> JECT <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 <br /> Ea accident <br /> X ANYAUTO BODILY INJURY(Per person) $ <br /> A OWNED SCHEDULED PHPK2716952-00 07/01/2025 08/31/2026 BODI LY I NJ U RY(Pe r accide nt) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 <br /> A EXCESS LAB CLAIMS-MADE PHUB921179-000 07/01/2025 08/31/2026 AGGREGATE $ 4,000,000 <br /> DED I I RETENTION $ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE F I ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ElN/A E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> Sexual Abuse&Molestation Per Occurrence $1,000,000 <br /> A Professional Liability PHPK2716952-00 07/01/2025 08/31/2026 Aggregate $1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> "City of Santa Ana,officers,agents,employees,and volunteers are named as additionally insured on this policy pursuant to written contract,agreement,or <br /> memorandum of understanding.Such insurance as is afforded by this policy shall be primary,and any insurance carried by City shall be excess and <br /> noncontributory.Waiver of Subrogation applies in favor of the Additional Insureds.30 Day Notice of Cancellation is in favor of the Certificate Holder. <br /> Digitally signed <br /> TU Tran by Tu Tran <br /> Nguyen <br /> Nguyen 152040-0'00' APPROVED <br /> By Tu Tran Nguyen at 3:20 pm,Sep 02,2025 <br /> CERTIFICATE HOLDER CANCELLATION <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,Executive Director 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 /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />