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A� �® CERTIFICATE OF LIABILITY <br />DATE ) <br />TYPE OF INSURANCE <br />THE FXPIRA71ON DATE THEREOF, NOTICE WILL BE DELIVERED IN <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 COVERA E AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE I SUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the <br />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 />DICKERSON EMPLOYEE BENEFITS INSURANCE SERVICES <br />1918 Riverside Drive <br />Las Angeles, CA 90039 <br />CONTA <br />Nora Wolkoff <br />vie <br />E�AAR <br />AoeRess. <br />05121/2018 <br />(323) 662-7200 <br />UYSUREFUSI AFFORDING COVERAGE NAIC F <br />INSURER A: Philadelphia lndemnl Insu nce Com an 21044 <br />INSURED Charitable Ventures of Orange County <br />INSURER B: New York Marine and Gene 1 Insurance Company 16608 <br />_ <br />INSURER C: <br />GEN'L AGGREGATE <br />XI POUCV <br />LIMIT APPLIES PER: <br />PRP LOCIECT <br />1505 E. 17th Street, Suite 101INSURERD: <br />INSURER E: ------ <br />Santa Ana, CA 92725 <br />INSURER F: <br />ANY AUTO <br />AUTOWNED <br />OSS AUTOS LEO <br />NON -OWNED <br />HIREDAUTDS X AUTOS <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NA IED ABOVE FOR THE POLICY PERIOD <br />INDICATED. N01WTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCU IENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HE IN 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 />THE FXPIRA71ON DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Ci of Santa <br />IY Ana <br />POLICY NUMBER <br />POLICYEFF <br />MMIDD <br />POUCYEIW <br />MWO <br />LIMITS <br />A <br />GENERALLUUNUTY <br />X COMMERCIAL GENERAL LIABILITYrX <br />CLAIMSMADE OCCUR <br />I... <br />r <br />I <br />PHPK1634585 <br />05121/2017 <br />05121/2018 <br />EACH CURRENCE 51,000000___-. <br />PREMISES Eaenvnenre S10D000 <br />MEO P(Arryamperson) 55,000 <br />PERS NAL 6 ADV INJURY s1.000,000 <br />_ <br />GENEF ALAGGREGATE 52.000,000 <br />GEN'L AGGREGATE <br />XI POUCV <br />LIMIT APPLIES PER: <br />PRP LOCIECT <br />PROD TS-COMPIOPAGG S2000000 <br />A <br />AUTOMOBILEWBILITY <br />X <br />ANY AUTO <br />AUTOWNED <br />OSS AUTOS LEO <br />NON -OWNED <br />HIREDAUTDS X AUTOS <br />—I--� <br />I I <br />I <br />PHPK7634585 <br />0512112017 <br />05!2112018ANA <br />M qED IN UMI $1000000 <br />RY(Per person) 5 <br />RY(Pwr dwt) 5 <br />E <br />S <br />$EACH;CCURRENCE <br />S <br />X <br />UMBRELLA LIAR <br />E%CESS UAB <br />X <br />OCCUR <br />c1AIMS.MADE <br />�� <br />PHUB579022 <br />05/21/2017 <br />05/2112018 <br />RENCE 54,000,0A <br />54,000,000______ <br />DED I X I RETENTIONS 10,000 <br />_ <br />S <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIEfOR/PARTNER/ ECUTIVE YIN <br />OFFICFMEMBER EXCLUDED? Q <br />(MandetorylnNX) <br />If yea, des wUM <br />NIA <br />r <br />201700011228 <br />05/11i1017 <br />05111/2018 <br />X STATU- OTH. <br />--- <br />E.L. HACCIOENi $1000000 <br />---- <br />E.L. DI EASE -EA EMPLOYEE $1,000,000 <br />_ <br />11 <br />E. L. DIpEASE- POLICY LIMIT 51,000,000 <br />1r <br />I <br />F_ <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORO tell, Addldoml Re rte 9chedul0. It mm apace is MvInd) <br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are Included as additional insureds with respect to claims arising out of the <br />Aerations and uses performed by or an behalf of the named insured, such Insurance as Is afforded by this policy is primary and is not additional to or contributing <br />With any other insurance carded by or for the benefit of the additional insureds subject to policy terms and renditions. �� �•-, <br />Evidence Only as respects to Workers Compensation. _ rr�CJ„du�l,• ttV// <br />W <br />CERTIFICATE HOLDER CANCELLATION I <br />SHOULD ANY OF THE ABOVE DESCR BED POLICIES BE CANCELLED BEFORE <br />THE FXPIRA71ON DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Ci of Santa <br />IY Ana <br />ACCORDANCE WITH THE POLICY PRC VISIONS. <br />20 Civic Center Plaza, <br />The ACORD <br />AUmCROEO REPI)ESENTATNE <br />Santa Ana, CA 92701 <br />Nora Wolkoff <br />©1988-2010 ACORDT <br />All rights reserved. <br />ACORD 25 (2010105) <br />The ACORD <br />name and logo are registered <br />marks of ACORD <br />