KIDWORKS COMMUNITY DEVELOPMENT CORPORATION (CDBG 2016)

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4cC)ezb`v CERTIFICATE OF LIABILITY INSURANCE D I° °7 �--'� 6 /23 6/23/2016 16 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 Specializing in Insurance for Nonprofits CONTACT NAME: Certificate Issuance Team Comprehensive Insurance Services �N (949) 7D9 -$$0 (999 %709 -1668 ��- UV No): 26429 Rancho Parkway South ADDARIESS.in£o@ thecomprehensiveinsurance. com Suite 120 INSURER(s)AFFORDING COVERAGE NAICN Lake Forest CA 92630 - - _ _. _. INSURERA:NOnprofits Ins _Alliance of CA _ 11$45 INSURED INSURER B: KidWOrks Community Development Corporation _ INSURER C: 1902 W. Chestnut Ave. INSURER D: INSURER E Santa Ana CA 92703 INSURER F: COVERAGES CERTIFICATE NUMBER:GL /Auto /Umb REVISION NUMBER: 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 THIS CERTIFICATE MAY BE 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. INSR FI - -TADDL SUER POLICY EXP LTR TYPE OF N POLICY NUMBER MM DO YYYY (MMIDDNYYY i LIMITS X GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000 A � ]CLAIMS -MADE X OCCUR OAMAGETO RENTED PREMISE�Eaoccurrence) $ 500,000 _ $ 20,000 X 2016 - 45659 -NPO 7/1/2016 7/1/2017 MED EXP(Any one person) PERSONAL &ADV INJURY_ $ 1,000,000 GEN'LAGGREGATE -- LIMITAPPLIES PER GENERAL AGGREGATE $ 3,000,000 POLICY CY PRO- X _ LOC JECT 3,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT -(Re see dent) _ $ 1,000,000 X $ A ANY AUTO BODILY INJURY (Per person) ALL OWNED SCHEDULED AUTOS AUTOS 2016- 45659 -NPO 7/1/2016 7/1/201'7 � - _- BODILY INJUJU RY (Per accident) -- $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE (Per sodden L_ $ Is X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 _ AGGREGATE _ $ _ 1,000,000 A EXCESS LIAB CLAIMS -MADE _ UEO RETENTION _ 2016 - 45659 -oeB 7/1/2016 7/1/2017 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN _STATUTE ER $ ANY PROPRIETOWPARTNER /EXECUTIVE E L EACH ACCIDENT OFFICER /MEMBER EXCLUDED? uN /A - - - -- $ (Mandatory in NH) iEl DISEASE-EA EMPLOYE -- -- If yes, describe under - I EL DISEASE- POLICY LIMIT -- - $ DESCRIPTION OF OPERATIONS below A Social Service Professional 2016- 45659 -NPO 7/1/2016 7/1/2017 $1,000,000.4gg /1,000,0000oc A Improper Sexual Conduct 2016- 45659 -NPO 7/1/2016 7/1/2017 i $3,000, 000Agg /1,000,00DEa Cl DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required) City of Santa Ana its officers, employees, agents and volunteers are included as Additional Insured per attached City Agreement. 30 day notice of cancellation with 10 day notice of cancellation for non - payment of premium per policy provision. L CERTIFICATE HOLDER CANCELLATION m 4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana Community THE EXPIRATION DATE THEREOF-, NOTICE WILL BE DELIVERED IN Development; Agency ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE PO Box 1988 Santa Ana, CA 92704 -1988 Richard Eynon /JEREMY4�`�y!�._� © 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401)