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ACC>ROr CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 11`- � 4/18/2016 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 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 Certificate Issuance Team Comprehensive Insurance Services PHONE FAX (AIC, No,_ExtJ; ( 999) 709 -8800 (AaC, No): (949)709-1668 26929 Rancho Parkway South ADMDRESS: info@ the oomprehensiveinsurance.com Suite 120 _. ....INSURER(S) AFFORDING COVERAGE...... NAIC # Lake Forest CA 92630 INSURERA:Security National Insurance Co 33120 INSURED INSURER B KidWorks Community Development Corporation INSURER C: 1902 W. Chestnut Ave. COMBINED SINGLE LIMIT $ INSURER D: . ANY AUTO' INSURER E Santa Ana CA.. 92703 INSURER F: ........ _. _. ......... ......... COVERAGES CERTIFICATE NUMBER-WC PFVII -glnN NI IVIRIP -Pa THIS IS TO CERTIFY THAT THE 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 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THIS 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. 'INSR ADDLSUBR,. .. ........ ......... .. LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIY'YYY MFOiMIDDIYYYY LIMITS COMMERCIAL GENERAL EACH OCCURRENCE $ CLAIMS -MADE OCCUR . ....... DAMAGE TO RENTED . — PREMISES (Ea occurrence) $ _ MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GENT. AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS - COMPIOP AGO $ OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) . ANY AUTO' BODILY INJURY (Per person) _ ALL OMED - SCHEDULED _ _... __ ...... AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NOWOWNED AUTOS PROPERTY DAMAGE..... ... $ ., -(Per accident) .. UMBRELLA LIAR .. OCCUR ... EACH OCCURRENCE EXCESS LIAR - CLAIMS-MADE . ......... AGGREGATE $ BED RETENTION $ $ WORKERS COMPENSATION PE.R OTH- AND EMPLOYERS'LIASILITY YIN STATUTE __.ER .... - .._. ANY PROPRIETORIPARTNER /EXECUTIVE _ OFFICER /MEMBER EXCLUDED? NIA E L EACH ACCIDENT $ 1 , 000' _... - 000,900 A (Mandatory in NH) SWC1101081 2/1/2016 2/1./2017 E L DISEASE -EA EMPLOYEE $... 1.. 000 000....... If yes, describe under , '... DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLUCY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,. Additional.. Remarks Schedule, may be attached if more space is required) 30 day notice of cancellation with 10 day notice of cancellation for non - payment of premium per policy provision. City of Santa Ana Community Development Agency 20 Civic Center Plaza PO Box 1988 Santa Ana, CA 92744 -1988 ACORD 25 (2014/01) INS025 (201401) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IIN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Richard Eynon/JEREMY l'bdd -204 A(;C)RD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD