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CERTIFICATE OF LIABILITY INSURANCE ❑ATE(MMIDDiYYYY) <br />11/2/2016 <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(les) 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 an this certificate does not confer rights to the <br />certificate holder In lieu of such endorsement(s). <br />PRODUCER <br />NAME. CT Certificate Issuance Team <br />Comprehensive Insurance Services <br />26429 Rancho Parkway South <br />AHC NE <br />No Ext: (949)���-8800 AAfC Na; {999j 709-1668 <br />E-MADDKESS:znfo@thecomprehensiveinsurance.com <br />Suite 120 <br />Lake Forest CA 92630 <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURERA:Non rofits Ins Alliance of CA 11845 <br />INSURED <br />INSURER B:COm WeSt InSu.rance Company 12177 <br />Delhi Center <br />INSURER C : i <br />505 E. Central AVe. <br />INSURER D: <br />INSURER E : <br />Santa Ana CA 92707 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER:CL/Auto/wC RFVISIf')N N11MRrP. <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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VWICH 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 />INSRLTR <br />LTR <br />TYPE OF INSURANCE <br />DL <br />SUER <br />POLiCYNUMBER <br />POLICY EFF <br />MMIDDIYYYY) <br />POLICY EXP <br />(MWCDIYYYYl <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE F—xl OCCUR <br />EACH OCCURRENCE g 1,000,000 <br />DAMAG R TE <br />PREMISES lEa occurrence $ 500,000 <br />? <br />X <br />2016-0137fi-HPO <br />1111/2016 <br />11/112017 <br />MED EXP (Anyaneperson) $ 20,000 <br />PERSONAL & ADV IhIJURY $ 1,000,000 <br />GEN'LAGGREGATE LIMiTAPPLIES PER: <br />PRO- <br />POLiCY QCT FXLOC <br />GENERAL AGGREGATE $ r 000, 000 <br />PRODUCTS - COMP/OPAGG $ 3,000,000 <br />$0 C�duCtible ;� <br />OTHER' <br />I <br />AUTOMOBfLE <br />LIA&UTY <br />CCM61NED SINGLU LIMIT <br />EaaccidantL $ 1,000,000 <br />BODILY 1�f,URY(Per person) <br />A <br />AN' AUTO <br />ALI_OVYNED SCHEDULED <br />AUTOS AUTCS <br />2016--01376-1120 <br />11/1/2016 <br />11/1/2017 <br />BODILY Per acrid ant) <br />I <br />X <br />NON-OWIMiED <br />HIREDA.UTOS X AUTOS <br />PROPERTY DAMAGE <br />Peracudent $ <br />$0 Dednc!iole $ <br />I UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE $ <br />EXCESS LIAO <br />CLAIWB -MADE <br />AGGREGATE <br />DED I RETEhITION $ <br />$ W <br />$ <br />WORKERS COMPENSATION <br />AND EMALOYERS' LIABILITY YIN <br />ANY P:ROPRiCTOR)PA.RTNER.axECIJTIVE <br />OFFICERIMEMBER EXCLUDED? ❑ <br />Nandatwy In NH) <br />f �//ees descrEhn undef <br />7EStRIPTi3ON OF OPERATIONS below <br />NfA <br />iX <br />WCV5900420 <br />1.1/1/2016 <br />I <br />11/1/2017 <br />I <br />iPER OTFE- <br />STATUTE ER <br />E.L. EACH ACCIDENT $ 1 000, 000 <br />EL DISEASE - EAEMPLOYEE s 1 000 400 <br />E.L. DISEASE - POLICY LIMIT .� 1 000 000 <br />A <br />Social Sery Professional <br />2015-01376-Npo <br />11/112016 <br />11/1/2017 <br />$3,000000Aggl1.00C,000Ccc $O Deductible <br />A <br />Improper Sexual, Conduct <br />2016 -01376 -Nap <br />11/112316 <br />11/1/2017 <br />$1000000Agg/1,000,3GOCcc $O Deductible <br />DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES [ACORD 101, Additional Remarks 3chadule, may be attached if mora space is required) <br />The City of Santa Ana its officers, employees, agents and volunteoss are included as Additional Insured <br />automatically per written contract or agreement per attached endorsement CG2026. 30 day notice of <br />cancellation with 10 day notice of cancellation for non-payment of premium per policy provision. This <br />insurance is Primary and Non-contributory per attached endorsement NIAC E61. <br />l_ L�Elillti^I�f�Nll J��. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Aria THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92702 <br />AUTHORIZED REPRESENTATIVE <br />Richard Eynon/JEREMY <br />U 1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014!41) The ACORD name and logo are registered marks of ACORD 1Vi t �* �tR,1 of r n ( <br />INS025{2OT411) �3(LfJ� fit } <br />ocacj IV - I -- 4 <br />