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CALIFORNIA FORENSIC PHLEBOTOMY
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Last modified
4/23/2021 3:22:05 PM
Creation date
4/11/2019 1:53:20 PM
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Contracts
Company Name
CALIFORNIA FORENSIC PHLEBOTOMY
Contract #
A-2019-036
Agency
POLICE
Council Approval Date
3/5/2019
Expiration Date
3/4/2022
Insurance Exp Date
7/11/2020
Destruction Year
2027
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CALIFOR-02 LAURAARROYO <br />CERTIFICATE OF LIABILITY INSURANCE DATE(MWODNYYY) <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLD8"5/ER.ITHIS <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 pOIICy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />f 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 endorsements . <br />ODUCERRIMIACT <br />P Propert & Casualty Services, Inc. <br />1551 North l astin Avenue <br />Suite 500 <br />Santa Ana, CA 92705 <br />PNONE <br />ac No, E.e : (714 5055550 AIC, Ne:(714) 975-8966 <br />E- <br />INSURERS AFFORDING COVERAGE <br />NAICB <br />INSURED <br />California Forensic Phlebotomy <br />5753 E. Santa Ana Cyn Rd. Suite G-553 <br />Anaheim Hills, CA 92807 <br />INSURER A: Evanston Insurance COm all <br />INSURERB:StarNet Insurance Com an <br />35378 <br />40045 <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />COVERAGES <br />NSURER F: <br />- -- � rr.amocn: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED <br />REVISION NUMBER: <br />BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR <br />OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN <br />EXCLUSIONS <br />AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />IS SUBJECT TO ALL <br />THE TERMS, <br />INSR ADDL SUBR <br />TR TYPE OF INSURANCE I SD POLICY NUMBER POLICY EFF POLICYEXP <br />A X COMMERCIAL GENERAL LIABILITY <br />lM9RS <br />CLAIMS -MADE OCCUR <br />EACH OCCURRENCE $ <br />2,000,000 <br />X M928506 11/17/2D18 11117/2019 <br />X Prof Liab- Claims Ma <br />DAMAGETORENTED <br />E <br />50000 <br />MEDEXP An one rson $ <br />5,D00 <br />GENLAGGRE ATE LIMIT APPLIES PER' <br />PERSONAL&ADV INJURY $ <br />2,000,000 <br />X POLICY � P� LOC <br />GENERAL AGGR GATE E <br />3,000,000 <br />OTHER: <br />PRODUCTS-COMP/OPAGG E <br />Included <br />A <br />PROF LIAB AGG $ <br />3,000,000 <br />AUTOMOBILE LIABILITY <br />COMBIN�SINGLE LIMB <br />t,000,Q00 <br />ANY AUTO SM928506 11/17/2018 11/17/2019 <br />OWNED SCHEDULED <br />$ <br />BODILY INJURY Per sown <br />AUpT�O�S ONLY AUppTOSWWNNEEDp <br />X AUTOS ONLY X N N TiY <br />BODILY INJURY Peraaitlerd <br />PROPERdY DAMAGE <br />Pe acti em <br />g <br />UMBRELLA LIAB <br />OCCUR <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />DED RETENTION$ <br />AGGREGATE <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />X PER OTH- <br />T <br />ANYPROPRIETORIPARTNEWEXECUTIVE YIN <br />OFa��R YI BER EXCLUDEDI ❑ <br />NIA <br />BNUWC0147463 <br />4/1212019 <br />4112/2020 <br />E.L EACH ACCIDENT <br />$ <br />1,000,000 <br />E.L. DISEASE - EA EMPLOYE <br />11000,000 <br />If yes, describe untler <br />DESCRIPTION OF OPERATIONS below <br />E.L DISEASE -POLICY LIMIT <br />$ <br />1,000,006 <br />DESCRIPTIONOFOPERATIONS/LOCATIONSIVEHICLES (ACORDIGI,AUCIUonal Remarks Schedule, maybeatMehe Vmorespacelsrequlnd) <br />The City of Santa Ana, its officers, employees, agents & representatives <br />are named as additional Insureds as respects to the General Liability policy <br />endorsement Included in the policy. Coverage is Primary and Non -Contributory, as required by written contract. <br />limits per <br />_CERTIFICATE HOLDER <br />City of Santa Ana <br />Attn: Risk Management D <br />20 Civic Center Plaza, 4th <br />Santa Ana, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />22 1o�Jn THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />J ACCORDANCE WITH THE POLICY PROVISIONS. <br />M. LAMBERt AU IJORD:ED REPRESENTATIVE <br />ACORD 25 (2016/03) _"-- - <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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