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�ecca®zcr" CERTIFICATE OF LIABILITY INSURANCE
<br />OATE(MM1OOIyYYY)
<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 />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: It the certificate holder is an ADDITIONAL INSURED, the policy(los) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in Ileu of such endorsement(s).
<br />PRODUCER Specializing in Insurance for Nonprofits
<br />NONE: Certificate issuance Team
<br />... ...
<br />Comprehensive Insurance services
<br />_,-._....................._—_.. _ .._......__...-.._
<br />PHONE
<br />HO Ns..Ext1 (949)709-8800 ....... 1 PAX N9),, <949YTon-sees
<br />.,..__ --- _....
<br />26429 Rancho Parkway South
<br />_, .........____..
<br />EMAIL
<br />A-MAJI, info . ...__._ _.__.
<br />Suite 120
<br />_......_ ............._. _.......
<br />INSURERS) AFFORDING COVERAGE NAIC9
<br />Lake Forest CA 92630
<br />INSURERA Nonprofits Ins_ Alliance of CA
<br />INSURED
<br />_
<br />INSURER 9:
<br />i "- .. ...
<br />BODILY INJURY (ParPersnnj $
<br />{
<br />NSURER O:
<br />America On Track
<br />-_ ......... ........_..,___....._-
<br />BO Box 4141
<br />_I,N9URERb ..............-..-.--.._.. ,...,.._._..
<br />NSURGRE:
<br />Tustin CA 92761-4141
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER:GL/Auto/ISC RFVIAHIM MIIMRFR•
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A80VE FOR THE POLICY PERIOD
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICI4 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 />Pull ..__,._.__. ...._.... ._._.—._.--IADDL SUBR!.. ____
<br />LTR TYPE OF INSURANCE 1
<br />LTGPOLICY NUMBER
<br />._.
<br />POLIdV EFf POLICY E%P_ ..,,. ...------------ .............. .._.-----
<br />(O YYY 3 `� LIMITS
<br />X COMMEROIAL GENERAL LIABILITY
<br />....
<br />EACH OCCURRENCE ! $ 1,000,000
<br />A CLAIMS -MARL �..X OCCUR
<br />-----
<br />hAN1AGE'T2573FNTC0' '._-- ..._
<br />PREMIES(Ea.,mmrsme) sA0,404
<br />X X2015 -06100 -NPO
<br />;$
<br />9/1J2tl15 9/1/2018 MED EXP �Myaia Person) $ 20 044
<br />I PERSONAL A ADV INIIJRV $ 1 040,000
<br />! GEN1 AGGREGATE LIMIT ARM me PER:
<br />( 1 GENERAL AG...G,R,EGATE 2,000,000
<br />JEU
<br />.(._. ..-.
<br />PRODUCT&=OOMP/OP 2
<br />_.. AGG,$-. ,000,400
<br />OTHER:
<br />Oedd$
<br />AUTOMOBILE LIABILITY
<br />._.
<br />N 1 tE LIMn
<br />i 1 a ono e '$ 1,444,404
<br />X
<br />A --- ��i
<br />i "- .. ...
<br />BODILY INJURY (ParPersnnj $
<br />{
<br />ALL OWNCO SCHEDULED
<br />.,..AUTOS AUTOS !2 015 -0 618 0 -NPO
<br />.
<br />._-...... .. ... -..
<br />= 9/lJ2plb pf1(20].S 900RY IN,IIIRY {Per acu!dexM1}�$
<br />HIREOAUTOS AUTOS ED
<br />!
<br />....., AUTOS
<br />-�
<br />PROPER'T'Y OAMACE
<br />( (pgl acrndeN} _. $
<br />S,
<br />...._ .....-.
<br />1 a 0arl.ruble $
<br />I UMBRELLA LIFE OCCUR (
<br />1
<br />I EACH OCCVRRENCE I$
<br />t aXCEeS LIAR CLAIMS -MADE ! i,
<br />_7. _....
<br />_
<br />j AGGREGATE $
<br />J
<br />-.,..,-
<br />DEO RE rENI'IONS
<br />(WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />i (OTFlTUTE�
<br />YIN
<br />t RH
<br />ANY PROPRIETORIPARTNENEXECUTIVE r
<br />OFFICERP,EM9ER EXCLUDEDP NIA I
<br />EL CACI ACGII?ENT 8- -.
<br />_
<br />(Mandatory in NH) (
<br />Una, das.dic under ! 1
<br />l CL DISEASE -EA EMPLOYE '$
<br />4 —
<br />DESCRIPTION OF OPERATIONS below 1
<br />El, DISEASE POLICY LIMIT $
<br />A Improper Sexual Conduct2015-061Bp-NPO
<br />I
<br />9J1/2p15 9/1/2010 $i,ppO,OpUAp011,D0O,pOUEaO $0 Deductible
<br />A Social Sery Professional 2015-06180-NPp
<br />i
<br />.9/1/2015 7/1/2018 $2,O90,C4UfTA00.00pEa 0. $0 Deductible'
<br />DESCRIPTION OF OPERATIONS I LOCATIONS J VEHICLES (ACORD 101, Additional Remarks Sohom.,
<br />may be adanhed It more space la rela rem
<br />City of Santa Ana, its officers, employees, agents and
<br />representatives are included as Additional Insured
<br />per attached agreement. 30 day notice of cancellation
<br />with 10 day notice of cancellation for non-payment
<br />of premium per policy provision,
<br />CERTIFICATE HOLDER CANCELLATION
<br />Q 198$-2014 ACORD CORPORATION. All rights reserved,
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />INS025 (201 not )
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 Civic Centel' Plaza
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />Santa Ana, CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />Richard Eynon/JEREMY
<br />Q 198$-2014 ACORD CORPORATION. All rights reserved,
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />INS025 (201 not )
<br />
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