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CERTIFICATE OF LIABILITY INSURANCE DAT /
<br /> 0 9/27/27/2024 Y)
<br /> 024
<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 CONTACT he stone
<br /> McGriff Insurance Services,LLC NAME: Rileyy p
<br /> 3400 Overton Park Drive SE (A/C,No,Ext: 404 497-7500 FAX
<br /> No):
<br /> Suite 300 E-MAIL rile she stone me riff.com
<br /> Atlanta,GA 30339 ADDRESS: y' p °� g
<br /> � ) F
<br /> in I If I A VAMO I IL Vs E A. e.<ingto suranc Comp y 19437
<br /> INSURED -07 t t
<br /> Care Ambulance Services,Inc. I E ri 'r a
<br /> 1517 West Braden Court INSURar,C:XL Insurance America,Inc. 24554
<br /> Orange,CA 92868
<br /> INSURER D
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:FKEDTWLP 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 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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD POLICY NUMBER MMIDD/YYYY MMIDDIYYYY
<br /> A X COMMERCIAL GENERAL LIABILITY 6798591 10/01/2024 10/01/2025 EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED 25,000
<br /> PREMISES Ea occurrence $
<br /> MED EXP(Any one person) $ 5,000
<br /> X X PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY❑ PRO ElLOC PRODUCTS-COMP/OPAGG $ 1,000,000
<br /> JECT
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY RAD500047609 10/01/2024 10/01/2025 COMBINED SINGLE LIMIT 5,000,000
<br /> Ea accident $
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED X X BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br /> DED I I RETENTION$ $
<br /> C WORKERS COMPENSATION RWD300095509 10/01/2024 10/01/2025 X I PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N/A N/A X
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> A Professional Liability 6798591 10/01/2024 10/01/2025 Per Claim $ 1,000,000
<br /> Aggregate $ 2,000,000
<br /> $
<br /> $
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
<br /> Aggregate Limit per location only applies where required by written contract.
<br /> Umbrella/Excess Follows Form.
<br /> The City of San Ana is included as Additional Insureds as respects to General Liability and Automobile Liability,as required by written contract. Waiver of Subrogation is in
<br /> favor of the Additional Insured for the General Liability,Auto, and Workers'Compensation policies referenced herein as required by written contract.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRI
<br /> THE EXPIRATION DATE THEREOI HORN Risk ManaganentDivisim
<br /> ACCORDANCE WITH THE POLICY PRC rs, REVIEWED&APPROVED BY:
<br /> of A Aai/44
<br /> City of Santa Ana AUTHORIZED REPRESENTATIVE
<br /> 20 Civic Center Plaza,4th floor Risk Management Specialist
<br /> Santa Ana,CA 92702
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<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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