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DELHI CENTER (4)
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Last modified
8/9/2018 1:36:04 PM
Creation date
8/9/2018 1:35:19 PM
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Contracts
Company Name
DELHI CENTER
Contract #
A-2018-178-15
Agency
Community Development
Council Approval Date
7/17/2018
Expiration Date
7/16/2019
Destruction Year
2023
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A� " CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDDIYYYY) <br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />06/26/2018 <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(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 rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT Certificate Issuance Team <br />NAME: <br />Comprehensive Insurance Services <br />p DNW (949) 709-8800 aC (949) 709-1668 <br />Ex : Nq: <br />26429 Rancho Parkway South <br />E-MAIL info@thecomprehensivelnsurance.com <br />EACH OCCURRENCE $ 1,000,000 <br />ADDRESS: <br />INSURERS AFFORDING COVERAGE NAIC N <br />Suite 120 <br />INSURER A: Nonprofits Insurance Alliance of California 11845 <br />Lake Forest CA 92630 <br />INSURED <br />INSURER B: CompWest Insurance Company 12177 <br />Delhi Center <br />INSURER C: <br />505 E. Central Ave. <br />INSURER D: <br />INSURER E: <br />1 INSURER F: <br />Santa Ana CA 92707 <br />COVERAGES CERTIFICATE NUMBER: CL17103103057 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 REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE 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 />LTR <br />TYPE OF INSURANCE <br />ADDLSUoK <br />INSD <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM/DDIYYYY) <br />POLICY EXP <br />(MM1DDNYYYL <br />LIMITS <br />X COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE $ 1,000,000 <br />CLAIMS -MADE ® OCCUR <br />PREMISES Ea occurrence $ 5001000 <br />MED EXP (Any one person) $ 20,000 <br />PERSONAL &ADV INJURY $ 1,000,000 <br />A <br />Y <br />2017 -01376 -NPO <br />11/01/2017 <br />11/01/2018 <br />GEN'LAGGREGATE LIMIT APPLIES PER: <br />GENERALAGGREGATE $ 3,000,000 <br />X POLICY ❑ JECT F—] LOC <br />PRODUCTS - COMP/OP AGG $ 3,000,000 <br />$0 Deductible $ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT $ 1,000,000 <br />Ea ac Irani <br />BODILY INJURY (Per person) $ <br />ANYAUTO <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />2017 -01376 -NPO <br />11/01/2017 <br />11/01/2018 <br />BODILY INJURY (Per accident) $ <br />PROPERTY DAMAGE $ <br />Per accident <br />X <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />$0 Deductible $ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION $ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY y/N <br />ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory In NH) <br />NIA <br />WCV590042002 <br />11/01/2017 <br />11/01/2018 <br />X STATUTE ETPER H <br />EACH ACCIDENT $ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS Win.E.L. <br />DISEASE -POLICY LIMIT $ 1,000,000 <br />A <br />Social Service Professional Liability <br />Improper Sexual Conduct Liability <br />2017 -01376 -NPO <br />11/01/2017 <br />11/01/2018 <br />$3,000,000/1,000,000 Aggregate/Occurr. <br />$1,000,000/1,000,000 Aggregate/Occur. <br />$0 Deductible <br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe akached If more space Is required) <br />The City of Santa Ana its officers, employees, agents and volunteers are included as Additional Insured automatically per written contractor agreement per <br />attached endorsement CG2026. 30 day notice of cancellation with 10 day notice of cancellation for non-payment of premium per policy provision. This <br />insurance is Primary and Non-contributory per attached endorsement NIAC E61. <br />CERTIFICATE HOLDER CANCELLATION <br />©1988.2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92702 <br />yarw.�j <br />©1988.2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />
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