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2-1-1 ORANGE COUNTY
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Last modified
6/27/2019 8:37:20 AM
Creation date
7/6/2018 2:44:16 PM
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Contracts
Company Name
2-1-1 ORANGE COUNTY
Contract #
A-2018-133-07
Agency
COMMUNITY DEVELOPMENT
Council Approval Date
5/15/2018
Expiration Date
6/30/2019
Insurance Exp Date
2/1/2020
Destruction Year
2024
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211 UU-U000 <br />1 <br />D02121/2 o1Y8 <br />zt2v2a <br />ACG%RL? CERTIFICATE OF LIABILITY INSURANCE <br />�---'' <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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 pollcy(Ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, sub)ect 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 cortlfloate holder In lieu of such endorsements . <br />PRODUCER License # 0564249 <br />C7 <br />Heffernan Insurance Brokers <br />18004 Sky Park Circle, Suite 210 <br />Irvine, CA 92614 <br />aCNNo, Enl: 1 949) 771.3400 F Nel; 949) 771.3401 <br />EMAIL <br />DRESS: <br />INSURERl81 AFFORDING COVERAGE <br />NAIC <br />INSURER AI Nonprofits Insurance Alliance of California <br />01184 <br />INSURED <br />INSURER 8: BE Insurance Corporation <br />39217 <br />INSURER C: <br />2.1-1 Orange County <br />1505 E. 17th Street <br />Suite 108 <br />INSURER D I <br />INSURER E: <br />Santa Ana, CA 92705 <br />INSURER F: <br />_ <br />COVERAGES CERTIFICATE NUMBER REVISION NUM,PER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOWHAVEBEEN ISSUEDTOTHE INSURED NAMEDABOVE FOR THE POLIOY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTC WHICHTHIS <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 />TYPE OF INSURANCE <br />ADSDLSUBR <br />MIDPOLICY <br />POLICY NUMBER <br />POLICY EFF <br />E%p <br />LIMITS <br />A <br />X <br />I COMMERCIAL GENERrAL,LIABILITY <br />CLAIMS -MADE a OCCUR <br />X <br />201803104NPO <br />02/01/2018 <br />02101/2019 <br />EACH OCCURRENCE <br />1,000,000 <br />OREAGE9 E E T ® <br />500,000 <br />MED EXP iAny one .man <br />20,000 <br />PERSONAL&ADV INJURY <br />a 1,000.000 <br />AGGREGATE LIMIT APPLIED PER: <br />ElPOLICY jEpL¢f —x—j LOC <br />GENE RALAGG EGATE <br />21000,000 <br />GENT <br />PRODUCTS � COMPIOP AGO <br />2,000,000 <br />_ <br />IDTHFR_...._._.-- <br />Sexual Mlsoondu <br />$ 1,000,000 <br />A <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />1Eau.CnldDW)� <br />1,000,000 <br />ANYAUTO <br />OWNED SCHEDULED <br />AUTO' ONLY AUU�TTNO�n,,W� <br />201803104NPO <br />02/0112018 <br />02101/2019 <br />BODILY INJURY Far mrean <br />BODILY INJURY Peraocldmt <br />S <br />Peoac RJeYtDAMAGE <br />X <br />p <br />Al1i0S ONLY X AUf09 OXEV <br />$ <br />A <br />X <br />UMBRELLA LIAB <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />201803104UMBNPO <br />02/01/2018 <br />0210112019 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />AGGREGATE <br />21000,000 <br />CED X I RETENTIONS 10,000 <br />WORKERS COMPENSATION <br />YIN <br />AApNNFFYP CCPRRO�PRIETORIPARTNEW ECUTNE ❑ <br />(MurlldBtOlyin NH) E%CLUDEO'I <br />0 yy00a describe under <br />OPERATIONS below <br />DESGIRIlity- <br />N /A <br />PER <br />aTATIL R <br />EHMLOYES1ALIITY <br />E.L. EACH ACCIDENT <br />F.L. DIDE'ASE - EA EMPLOYEE <br />$ <br />E.L. DISEASE POLICY LIMIT <br />B <br />DisabilityAD&D•Trav <br />DD-Tra <br />201$03104ACC <br />02/01/2018 <br />02101/2019 <br />Limit <br />50,000 <br />A <br />Prof. LlablOty <br />201803104NPO <br />02/01/2018 <br />02101/2019 <br />Per Occurrence <br />1,000,000 <br />DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES ( CORD IOI, Addlllonml Rommrks Schedule, ma beaUachsd Bmars spaas is T!mdl <br />Re: As Per Contract or Agreement on File with Insured. City of Santa Ana, Community Development Agency is included as an additional Insured (Primary) on <br />General Liability policy per the attached andorsement, if required. <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OFTHEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Cityof Santa Ana <br />Community Development Agency. <br />THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Administrative Services Division M•25 <br />AUTFIORIZ90 REPRESENTATIVE <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />AW <br />AGORD 25 (2016103) © 1988.2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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