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ACORO® CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MM/DD/YYYY) <br />`.^✓ <br />3/9/2018 <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(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER Bolton & Company <br />E. Foothill Blvd., Suite 100 <br />Pasadena, CA 91107 <br />CONTACT <br />NAME3475 <br />PHONE 626 799 -7000 qC No: 626 683-2117 <br />E-MAIL <br />ADDRESS: <br />INSURERSAFFORDINGCOVERAGE <br />NAICM <br />3/1/2018 <br />INSURERA: Philadelphia Indemnitv <br />18058 <br />www.boltonco.00m 0008309 <br />INSURED <br />YMCA of Orange County <br />13821 Newport Avenue Suite 200 <br />INSURERS: Quality Comp, Inc. <br />38865 <br />INSURERC: <br />INSURERD: <br />DAMAGE TO REN TED <br />PREMISES Ea occurrence $1 000 000 <br />Tustin CA 92780 <br />INSURER E: <br />✓ Includes Sexual Abuse Coverage <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 40765470 REVISION NUMBER: <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 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDLSUBR <br />POLICYNUMBER <br />POLICY EFF <br />MMIDDNYYY <br />POLICY EXP <br />MM/DOIYYYY <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />�/ <br />PHPK1764890 <br />3/1/2018 <br />1/1/2019 <br />EACH OCCURRENCE $1000000 <br />CLAIMS -MADE OCCUR <br />DAMAGE TO REN TED <br />PREMISES Ea occurrence $1 000 000 <br />MED EXP (Any one parson) $20000 <br />✓ Includes Sexual Abuse Coverage <br />PERSONAL&ADV INJURY $1000000 <br />GENT AGGREGATE LIMIT APPLIES PER: <br />GENERALAGGREGATE $2,000,000 <br />POLICY ❑jECOT LOC <br />PRODUCTS-GOMP/OPAGG $2000000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />PHPK1784890 <br />3/1/2018 <br />1/1/2019 <br />COMBINEDSINGLE LIMIT $1000000 <br />BODILY INJURY (Per person) $ent <br />✓ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Par accident) $ <br />) <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE $ <br />Par accident <br />A <br />,/ <br />UMBRELLA LIAB <br />�/ <br />OCCUR <br />PHUB619703 <br />3/1/2018 <br />1/1/2019 <br />EACH OCCURRENCE $15000000 <br />AGGREGATE $15.000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DEO RETENTION$ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />0150820317 <br />1/1/2018 <br />1/1/2019✓ <br />STATUTE ERH <br />E.L. EACH ACCIDENT $1,000,000 <br />ANYPROPRIETOMPARTNERIEXECUTIVE OFFCEWMEMBEREXCLUDED? <br />I❑N <br />NIA <br />E.L. DISEASE -EA EMPLOYE $ <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />EL. DISEASE -POLICY LIMIT $1000000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />GL Additional Insured applies per CG20260413 attached. GL Primary & Non -Contributory Wording applies per PIGLOO50712 attached. <br />GL Cancellation Clause applies per PICANXAICH020511 attached. <br />Branch: AO; Activity: Santa Ana Financial Assistance Program; Group: Loma Vista Childcare and SA Branch; Dates: 7/1/17 - 8/30/17. <br />Additional Insured(s): The City of Santa Ana, its officers, employees, agents and volunteers. xd� <br />The City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Ci of SAna COmmUI Development THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />A <br />City <br />Santa ants P ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE <br />Candice Solarz <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />40765470 1 18-19 GL AcdO EXCESS 15-19 WC I Nancy Cadwallader 13/9/2018 1:23:25 PH (PST) I Page 1 of 4 <br />