|
EXHIBIT 2
<br />MERCY -2 OF ID: SD
<br />'4t,✓ ®' CERTIFICATE OF LIABILITY INSURANCE
<br />GA0912112018Y)
<br />TYPE OF INSURANCEIME.
<br />09121/2018
<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 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 />Insurance Services, LLC
<br />5611 LittlerDufour
<br />Drive
<br />Hun Littler Drive
<br />Huntington Beach, CA 92649
<br />Stephanie Dufour
<br />COMEACT Stephanie Dufour
<br />PHONE 714.369-2998 FAX
<br />0 Ev • Ic N0: 714-840-6357
<br />I
<br />ADDRESS, Staphanle@dufaurinsurance.com
<br />INSURER(S) AFFORDING COVERAGE NAIC#
<br />INSURERA:Great American Insurance Coma 16691
<br />INSURED Mercy House Living Centers
<br />P.O.Sox 1905
<br />Santa Ana, CA 92702
<br />INSURERB:Great American Insurance Coma 16691
<br />INSURERC:NOVA Casualty Company 42552
<br />[NsuRER°.Great American Insurance Group 37532
<br />Y
<br />INSU'=Philadelphialndemni 18058
<br />PAC426088203
<br />PAC426088203
<br />NSURER F:
<br />85102/2018
<br />05102/2019
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS 18 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />LTR
<br />TYPE OF INSURANCEIME.
<br />400L
<br />SUER
<br />MauPOLICY
<br />NUMBER
<br />POLICYP
<br />IOLIC
<br />JJP
<br />UNITS
<br />GENERAL ABILITY
<br />EACHOCCURRENCE $ 1,000,00
<br />A
<br />A
<br />X COMMERCIAL GENERALLIFBIUTY
<br />CLAIM84AOE Q OCCUR
<br />X Prof. Liability y
<br />Y
<br />PAC426088203
<br />PAC426088203
<br />05102/2018
<br />05/0212018
<br />85102/2018
<br />05102/2019
<br />PREMISES(Ea ocurenea$ 100,00
<br />MED EXP Any Poe mon $ 10,00
<br />PERSONAL a ADV INJURY $ 1,000,00
<br />X Sex AbuselMiscond
<br />GENERALAGGREGATE $ 2,000,00
<br />A
<br />PAC426088203
<br />05102/2018
<br />05102!2019
<br />GEN'LAGGREGATEUMITAPPLIESPER,
<br />X POLICY
<br />JFQT P"LOC
<br />PRODUCTS-COMPIOPAGG $ 2,000,00
<br />Ded: $0 $
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINEOSINGLE LIMIT
<br />(Ea a Ids t 11000100
<br />A
<br />ANYAUTO
<br />Y
<br />CAP 188045404
<br />05/0212018
<br />05102/2019
<br />BODILY INJURY (Pei pmecn) $
<br />X
<br />ALLAlJT05 NED X AUTOSULED
<br />HIRED AUTOS X AUTOS"""`D
<br />BODILY INJURY(Per..Id.nt) $
<br />PRR CCIDEAM E S 130,00
<br />Comp/Coll Dad. $ 50
<br />X
<br />UMBRELLA LIAB X
<br />OCCUR
<br />EACH OCCURRENCE $ 5,000,00
<br />B
<br />EXCESS LIAR
<br />CIAIMSddADE
<br />Y
<br />UMB 426088303
<br />0510212018
<br />05102/2019
<br />AGGREGATE $ 5,000,00
<br />DEO I X I RETENTION$ 10000
<br />s
<br />C
<br />E
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Ya
<br />ANY PROPRIETORIPARINERIEXECUTNE
<br />daoryInftEXCLUOE07
<br />(Mandatory
<br />Byea RIPTIOa under
<br />OESCRIPTKIN OF OPERATIONS tlelow
<br />NIA
<br />CF1-WK-10000043.00
<br />(ACCIDENT) PHLY78928850
<br />0210812018
<br />1112112017
<br />0210812019
<br />1112112018
<br />X STAT X TH'
<br />DRY LIM
<br />E,LECHACCIDEr 1,000,09
<br />E.L OISEASE•EA EMPLOYE $ 1,000,00
<br />E,L DISEASE -POLICY UMR $ 1,000,00
<br />D
<br />Cyber Liability
<br />Y
<br />NLP3642944
<br />01/2912018
<br />0112912019
<br />Per Occ 1,000,00
<br />E
<br />D801 EPLI
<br />Y
<br />PHSD1173663
<br />1011712018
<br />1011712019
<br />Aggregate 1,000,00
<br />DESCMPTIONOPOPERATIONSILOCAnONSIVEHICLES(Attnch ACORDIDI,AddiUonal Ramarke Schedule,ifmoe.pocaler,ulrad) (I - p
<br />City of Santa Ana, its officers, employees, agents, volunteers and I P�.-w'nJ'r,/
<br />representatives are named additional insureds with respect to the operations LL//��
<br />of the named insured 6 this policy is primary per the attached endorsement. )���� �m ,
<br />Workes compensation coverage excluded, evidence only. 10 days notice of
<br />ay�'Vp
<br />cancellation for non-payment o£ premium._ /VI
<br />q (a,liIii
<br />City of Santa Ana
<br />Frank Hernandez
<br />20 Civic Center Plaza Box 1988
<br />Santa Ana, CA 92702
<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 />AUTHORIZED REPRESENTATIVE
<br />©19BB-2010 ACORD
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />41 N ..,
<br />
|