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A`"R" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 10/01/2024 <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 CONTACT Certificate Issuance Team <br /> NAME: <br /> Comprehensive Insurance Services PHONE <br /> Ext: (949)709-8800 ac,No): <br /> 26429 Rancho Parkway South E-MAIL ADORE Jeremy thecomprehensiveinsurance.com <br /> Suite 120 <br /> E ) C A E <br /> Lake Forest Acevedo IN suR• onpr t r nc a f a or I g023 <br /> INSURED <br /> � iNSUREYBU: <br /> Community Health Initiative of Orange County INSURER C: <br /> 1505 E.17th Street,Suite 108 INSURER D: <br /> INSURER E: <br /> Santa Ana CA 92705 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: CL2410407160 REVISION NUMBER: <br /> THIS IS TO CERTIFYTHAT 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAYBE 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 TYPE OF INSURANCE ADDL UBR POLICY NUMBER M�DD YYYYMLICY EFF O DD YYYY LIMITS <br /> ICY EXP <br /> LTR INSD WVD <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE_7CLAIMS-MADE �OCCUR PREM SESORENTE Ea occur ence $ 500,000 <br /> MED EXP(Any one person) $ 20,000 <br /> A Y Y 2024-44927 10/15/2024 10/15/2025 PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY PRO- FX LOC PRODUCTS-COMP/OPAGG $ 2,000,000 <br /> JECT <br /> OTHER: $0 Deductible $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 <br /> Ea accident <br /> ANYAUTO BODILY INJURY(Per person) $ <br /> A OWNED SCHEDULED 2024-44927 10/15/2024 10/15/2025 BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> X HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY /� AUTOS ONLY Per accident <br /> $0 Deductible $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE El <br /> E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> Social Service Professional Liability $1,000,000/1,000,000 Aggregate/Occ <br /> A Improper Sexual Conduct Liability 2024-44927 10/15/2024 10/15/2025 $2,000,000/1,000,000 Aggregate/Occ <br /> $0 Deductible <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> City of Santa Ana,officers,agents,employees,and volunteers are included as additionally insured on this policy pursuant to written contract or written <br /> agreement per attached endorsement NIAC E61.Such insurance as is afforded by this policy shall be primary,and any insurance carried by City shall be <br /> excess and noncontributory per attached endorsement NIAC E61. 30 day notice of cancellation with 10 day notice of cancellation for non-payment of <br /> premium per policy provision. Waiver of Subrogation applies per attached endorsement NIAC E26. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> City of Santa Ana ACCORDANCE WITH THE POLICY PRO) <br /> Risk Managrrnent f?iyisirnt <br /> Risk Management Division <br /> AUTHORIZED REPRESENTATIVE �?'� REVIEWED&APPROVm BY: <br /> 20 Civic Center Plaza nn of n fil n A <br /> GCV o <br /> Santa Ana CA 92702u <br /> ® Risk Management Specialist <br /> ©1988-2015 ACOF <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />