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CONSCIOUS BREAK, INC. 2
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CONSCIOUS BREAK, INC. 2
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Last modified
6/22/2020 1:13:51 PM
Creation date
5/23/2018 9:09:21 AM
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Contracts
Company Name
CONSCIOUS BREAK, INC.
Contract #
N-2018-069
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
6/30/2019
Insurance Exp Date
12/30/2018
Destruction Year
2024
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ACORff CERTIFICATE OF LIABILITY INSURANCE <br />OATEIMMMDNYYY} <br />02114/2018 <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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the forms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />eertiAcate holder In lieu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />NAME...__....,_ <br />NMC Insurance Services <br />P.O. Box 2159 <br />rHOtJIE�1 (949) 208-0929_,,... �1ac Not: (949} 9169929 <br />E MXIL seMce@nmcins.com <br />INSURER(S) AFFORDING COVERAGE <br />NAICI <br />Laguna Hills CA 92653 <br />INSURERA: U.S. LIABILITY INSURANCE CO. <br />INSURERS <br />EACH OCCURRENCE <br />INSURED <br />INSURERc: <br />PREMISES Eulrancc <br />Conscious Break Inc... N'"VL 11 I' I"' I <br />1 Older <br />INSV0.ER 0 <br />j 5,000^ <br />INSURER E <br />Trabuco Canyon CA 92679 <br />INSURERF'. <br />Il iiIII 10YAIzilnI116FT:1:71 <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. LIMBS SHOWN MAYHAVE BEEN REDUCED BYPAID CLAIMS, <br />ILTR <br />1YPEOFINSURANCE <br />POLICY NUMBER I <br />POLICYE)& <br />(MMMDIYYYY1 <br />LIMITS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />X CI -AIMS -MACE MAGE U OCCUR <br />EACH OCCURRENCE <br />$ 1,000,000 <br />PREMISES Eulrancc <br />4 100,000 <br />ME" F p(My pno person! <br />j 5,000^ <br />PERSONAL &ADV INJJRY <br />$ 1,000,000 <br />A <br />CL 1789714A <br />12Mf?.017 <br />12/302018 <br />GEHERN. AGGR(I TATE <br />$ 2,000,000 <br />GEN'L <br />X <br />A6GR�,ATE! IMIT MPLIE, PER <br />POLY'( PRO <br />.ECT E] WC <br />PRODG^TS -0OM1IPIOP AG -11 <br />In ClUdad <br />Professional Liability <br />$ Included <br />Q KtR <br />AUTOMOBILE <br />LIABILITY <br />' <br />CGMBWED SIN aLH LIIAIT <br />Ea awNernt <br />$ Included <br />I BODILY INJURY(Perparsonl <br />$ <br />AIJYAUTO <br />X <br />PLL O'ATIED , SCHEDULED <br />Aur)S AUTO' <br />ALTOWIED <br />HIRED AUTOS X ALTOS <br />S <br />CL 1789714A <br />12/302017 <br />12(502018 <br />BODILY uJJURviPpr awtaertl <br /># <br />UMBRELLA LIAROuCUR <br />EXCESS LIAe tLAInA."rlA0.0E <br />GED RETENTIONS <br />a Vv PI <br />�\I <br />EACH OC URRENCE <br />$ <br />AGGREHIr_E <br />$ <br />g <br />WORHERSCOMPENSATIN <br />O <br />AND EMPLOYERS'LIABILITY YIN <br />PNY :F'OFRIErOR/PAFTNE <br />OPICERMIE10SEERi EXCLUDED NECUTIVE <br />NIA <br />�„✓" <br />PEF u + <br />TATUTc <br />EL 4CH ACCIDENT <br />F_L I`EASE-E?EMPLaE <br />$ <br />(M.,story In NHl <br />If yas, Jssvnbe tinder <br />UE'CNIP7IJH OF OVERA'IIDNS OPIo.v <br />.-� <br />'~ <br />E... 01SFA..E- POLICY LIMIT <br />j <br />Gar`�� <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD IDI, AEGIS gnel Rem ule, may be aaacnce it more opacr le requlretl) <br />The CRY of Santa Ana, its officers, employees, agents, and representative are additional insured per attached endorsement. <br />The City of Santa Ana <br />20 Civic Center Piz <br />Santa Ana, CA 92701 <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 />0=- <br />ACUHU 2O (zu14101) The ACORD name and logo are registered marks of ACORD <br />
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