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CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDDIYYYY)
<br />10 f 7 /2 016
<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) roust 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 lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT Certificate Issuance Team
<br />NAME:
<br />Comprehensive Insurance Services
<br />PHONE (949)709 8800 FAX (5t9i749-1666
<br />(AtC,No._Ext1., _._, _... _ .... .. 'AIC No',°,
<br />26429 ]2anetlo Parkway South
<br />E-MADDRESS info@thecomprehensiveinsurance.com
<br />INSURER(S)AFFORDING mCOVERAGE
<br />NAIL#
<br />Suite 12.0
<br />Lake Forest CA 92630
<br />msuRERA:Nonprofits Ins Alliance of CA
<br />11845
<br />INSURED
<br />Wyp
<br />*,,:.ao t Let
<br />_.._._..
<br />INSURERB:CompfinTest Insurance Company
<br />.....n...._.._....._._.,...._
<br />121.77
<br />INSURER C
<br />Delhi. Center
<br />505 E. Central Ave.
<br />_.
<br />INSURER E :',...
<br />._....... ........... ........_ . ........
<br />INSURERF:
<br />Santa Ana CA. 927U r
<br />COVERAGES CERTIFICATE NUMBER:GL/Auto/WC REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSIURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS.
<br />......._.....__._._....., .. _.....
<br />II flii
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUER'
<br />POLICY NUMBER
<br />POLICY EFF
<br />AIMIDDfYYYY
<br />FOLIC(" EXP _
<br />MMIDDIYYYY
<br />__.._..._...._.._.
<br />LIMITS
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1, 000.., 000
<br />A
<br />CL6�NM-hAAU'�C ��rCCUR
<br />UAMAGEToRE. ITTEF'._......_.....m.__...._._._.
<br />PRErdGCu(Ca oxurrencen
<br />500,000
<br />$X
<br />MEDEXP' Any one person)
<br />$ � m mmmm20,000
<br />2016-01376-NPO
<br />11/1/2016
<br />11/1/2017
<br />1
<br />PER ON/m L&ADVIN3JR'r
<br />$ 1,000,000
<br />GENFRAD AGGREGATE
<br />$ 3,000,000
<br />GENT AGGRCGATF LINUT APPLIES PER. {
<br />POLICY JECT l�. U.rr
<br />PRODILICJ - 2Gr if'OPAGG
<br />....... .......m..._,_.......
<br />$ 3,000,000
<br />OTHER.
<br />i
<br />$J DeduciON,
<br />$
<br />LIABlLITY
<br />�,:QIVFJ9 �IFD SflNGI_E LIMIT
<br />(Ea ec6dani.'
<br />$AUTOMOBILE 1, 000, 000
<br />BODILY INJURY (Per person l
<br />$
<br />A
<br />X
<br />ANY AUTO
<br />A,Ln✓ .aYu`NED 5 HECULEE,
<br />J U /.I,Ta3
<br />NGN 4]M1NNEU
<br />= X AUTOS
<br />ItlIR.1L'UP�UI' Gsr"
<br />701,6-01.376-MPO � ..
<br />��.� �
<br />a
<br />1111/2016
<br />r
<br />pµ,
<br />9� �
<br />11./1/2017
<br />..._.....
<br />I R001I Y ri 11);iF r aro der}
<br />_ .._. .._ ..
<br />P'RdJPERTY D
<br />+I���J? IIJa�li7P�,Aurrl/i�aE
<br />.
<br />e
<br />8
<br />UMBRELLA LIAR OCCUR
<br />^.. ,��
<br />EACH OCCURRENCE
<br />:r
<br />AGGREGATE
<br />$
<br />EXCEiSSLIAB CLAIMS -MADE �
<br />-
<br />CbE::� 4E i ENTICdM1I $ �
<br />�}
<br />`t,.
<br />B
<br />KERS I ON
<br />AND EMPLOYERS' LIABILITY+STATU
<br />ANN PROMEMBER EXCLUDED PR•.IETORiPARTNEEiE ECG...iTI'JE YIN N PA
<br />''.(Mandatory in NH) PFICE I�.
<br />+ �^�
<br />r ,y t, `\,..1
<br />WCV6900420
<br />11/1./2016
<br />11/1/2017'
<br />PER LF
<br />L EACHACCIDENT FR 1
<br />E..L.IDTtiE.A,SE-E,hErvrIPLOY"EE
<br />. $ ,...w._ 1.. 000, 0010..
<br />$ 1,000,000
<br />If ye ,, odescribe iunde�r
<br />-'
<br />DESCRIPTION OF OPERA'TIONI;'Sbelow
<br />E..L.DISEASE -POLICY Lltdi_ I
<br />$ 1,000, 000
<br />A
<br />Soc'.ial Sery ProfessionaL
<br />201.5-01376-HPO
<br />11/1/2016
<br />111112017
<br />'63.1740.000Agg/I.N09.0000cc $0 Deductible
<br />A
<br />Improper Sexual. Conduct
<br />2016-01376-IUPO
<br />11/1/2016
<br />11/112017
<br />!6f.00Un0i;.=k0g7N,G00,U�00�aa��c $0 Deductible
<br />DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101„ Additional Remarks Schedule, may be attached if more spade is required)
<br />The City of Santa Ana its officers, employees, agents and volunteers are included as Additional Insured
<br />automatically per written contract or agreement per attached endorsement CG2026. 30 day notice of
<br />cancellation with 1.0 day notice of cancellation for non-payment of premium per policy provision.
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702
<br />HUN
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF„ NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE.
<br />chard Evnon/JEREMY
<br />U 1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01)
<br />INS025 (201401 )
<br />The ACORD name and logo are registered marks of ACORD
<br />
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