BOYS & GIRLS CLUB OF SANTA ANA (2)-2017

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ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ODIYYYY) 08/01/2018 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Nilda Garcia .- NAME: Hays Companies PAHONNOEan, (909)243-8111 / AIC, No: 4200 Concours, Suite #350 E-MAIL ngarcia@hayswmpanies.com ADDRESS: INSURERS AFFORDING COVERAGE NAIC9 INSURERA: Arch Insurance Company 11150 Ontario CA 91764 INSURED INSURER B: Cypress Insurance Company 10855 Boys & Girls Clubs of Central Orange Coast '� INSURER C: 17701 Cowan, Suite 110 INSURER D: INSURER E: Irvine CA 92614 INSURER F: COVERAGES CERTIFICATE NUMBER: CL1852360822 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADULSUBR INSD MO POLICYNUMBER POLICYEFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 GIAIMS-MADE 71 OCCUR PREMISES Ea commence $ 1.000,000 Professional Liabilty, MED EXP (Any oneperson) $ 20,000 XSexual Misconduct 1.000,000 A Y AAPKGO028800 02/11/2018 02/11/2019 PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 3,000,000 POLICY E JECT PRO- F-13,000,000 LOC PRODUCTS-COMP/OP AGG $ SEXUALABUSECOV s 1,000,000 OTHER: AUTOMOBILE LIABILITY COMINEDSINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Par person) $ ANYAUM A OWNED SCHEDULED AUTOS ONLY AUTOS AAAUT0028800 02/11/2018 02/11/201 BODILY I NJURY(Per accident) $ HIRED NONAWNEO q PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident I Medical payments $ 5,000,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAR CLAIMS -MADE AAFXS0028800 02/11/2018 02/11/201 Or AGGREGATE $ DED I X RETENTION $ 10,000 WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITYY STATUTE ER E.EACH ACCIDENT $ 1.000,000 L. B ANY ECUTIVE ❑ eR NIA BOWC914957 06/01/2018 06/01/20 19 OFFCEMMEM ExcO ED (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 Property RIC: Spcl Form A AAPKGO028800 02/11/2018 02/11/2019 Blanket BPP: $1,011,000 Deductible: $1,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe adached if more space Is required) The City of Santa Ana is Additional Insured; CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD