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211 OC-0000 HRCTnA
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE 02/08/2019Y)
<br />02l0612019
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT'S 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 ri hts to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER License IS 0554249
<br />MqACM` T
<br />Heffernan Insurance Brokers
<br />18004 Skp Park Circle, Suite 210
<br />Irvine, CA 92614
<br />PHC -
<br />lac, E Exq: 1 (949) 771.3400 (A C, NPI:(949) 771_-3401
<br />E
<br />INSUBER(SIAPFORDIN_G COVERAGE
<br />N IC#
<br />_
<br />INSURERA:NonorofltsInsurance Alliance ofCalifornia
<br />101184
<br />INSURED 2-1-1 Orange County
<br />1505 E. 17th Street
<br />INSURER B:QBEInsurance CorpOratlon
<br />39217 --
<br />INSURER C:
<br />INSURER D:
<br />_
<br />Suite 108
<br />_
<br />INSURER E:
<br />Santa Ana, CA 92705
<br />INSURER F :
<br />C VERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<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 REOUIREMENT, 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 HEREINIS 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 />AOOL
<br />SUER
<br />POLICY NUMBER
<br />PODCYHFFDNYYYI
<br />POIJCY E%P
<br />UNITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LVUEUTY
<br />CLAIMSWADE TX OCCUR
<br />Improper Sexual Cond
<br />X
<br />201903104NPO
<br />02toinfl19 02/0112020
<br />EACH OCCURRENCE
<br />S 1,000,000
<br />DAMAGEETORR4NTO
<br />5 500,000
<br />X
<br />P IMv one oerson)
<br />S,__ 20,000
<br />_
<br />PERSONAL B ADV INJURY
<br />11000,000
<br />NL AGGREGATE LIMIT APPLIES PER.
<br />POLICY�jECVT uLOC
<br />_IS
<br />GENERAL AGGREGATE
<br />S 2,000,000
<br />IG
<br />_
<br />PRODUCTS-COMPA)PAG
<br />$_^ 2,000,000
<br />SOCIAL SERVICE
<br />5 1,000,000
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />201903104NPO
<br />02/0112019, 0210112020
<br />COMBINED SINGLE LIMIT
<br />1 S 1,000,000
<br />�5
<br />.X
<br />_
<br />0 IF r SCHEDULED
<br />A�U�kRTE( �S ONLY F AUOoTN,NOSYWVNNEEpp
<br />AUTOS ONLY X AUTOIONLV
<br />BODILY INJURY Per persons
<br />BODILY INJURY (Per accident'_,
<br />15
<br />PPOFgEAeno'4MAGE
<br />$
<br />A
<br />X
<br />UMBRELLALIAS X
<br />EXCESSUAB
<br />OCCUR
<br />CLAIMS -MADE
<br />1201903104UMBNPOQUOTE
<br />02/0112019 02/01/2020
<br />EACH OCCURRENC°
<br />2,000,000
<br />AGGREGATE
<br />_S
<br />' $ 2,000,000
<br />OED RETENTIONS
<br />S
<br />j
<br />WORKERS COMPENSATION
<br />ANDEMPLOYERS'LIABILITY
<br />ANVPROPRIETOR?XCLUDEIE%ECUTIVE YIN
<br />OFFICEPIMEEMBER !EXCLUDED? �IINIA
<br />(Mentlde-1,e and
<br />If yes. desenbe under
<br />DESCRIPTION OF OP RATIONS peiaw
<br />PER OTH-
<br />"E_
<br />E.L. CHA C ENT
<br />S
<br />EL.FACHAE-EA EMPLOYEE
<br />,.,,_,_,.,,,.,
<br />S
<br />—
<br />E.L. DISEASE -POLICY LIMIT
<br />--
<br />S
<br />g
<br />201903104ACC
<br />02/0112019 02/01/2020
<br />Aggregailet
<br />1,000,000
<br />�Dlsabfiity-AD&D-Trav
<br />A
<br />Professional Liabili
<br />I201903104NPO
<br />I
<br />07JO112019 02O112020
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES IACORD 101, AComonal Remarks Schedule, me W allachetl a more space la nqulndl
<br />Re: As Per Contract or Agreement on File with Insured. City of Santa Ana, Community Development Agency Is included as an additional insured (and Primary)
<br />on General Liability policy per the attached endorsement, If required.
<br />TE HOLDER
<br />rAMrCI I ATInAd
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />1AUTHOMEO
<br />Community Development Agency,
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Administrative Services Division M-25
<br />REPRESENTATIVE
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />//f7L--�
<br />ACORD 25 J2015103) 01988.2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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