Laserfiche WebLink
AE� H CERTIFICATE OF LIABILITY INSURANCE <br />GATE 412011YYYV) <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 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 endorsemenk(s). <br />PRODUCER <br />C <br />ONAR <br />HIScox Inc. d/b/a/ HISCOX Insurance Agency In CA <br />520 Madison Avenue <br />$end Floor <br />PHONE (888) 202-3007 AIC No: <br />EMAIL <br />ADDREss: contact@hiscox.com <br />INSURER ($) AFFORDING COVER AGE <br />_. <br />NAIC# <br />NEW York, NY 10022 <br />_ <br />INSURER A: HISCOX Insurance Company Inc <br />T10200 <br />INSURED <br />LKHC Consulting <br />28D86 Via Del Cerro <br />INSURER B 1 <br />INSURER C : <br />INSURER O i <br />San Juan Capistrano CA 92675 <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES Or 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 <br />TYPE OF INSURANCE <br />ADDLSUBR <br />POLICYNUMBER <br />POLICY EFF <br />MMMdDIYyYYI <br />POLICYEXP <br />(MMiDDNYYY)LIMIT9 <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />EACHOCCURRENCE <br />S 2000,000 t" <br />PREMISES Es occurs ce I_$ <br />100,004 <br />MED EXP (Any one arson <br />$ 5,000 <br />X <br />Primary & Non Contributory <br />PERSONAL &ADV INJURY <br />$ 2000000 <br />A <br />Y <br />Y <br />UDC-2086768-OGL-18 <br />10120/2018 <br />10120/2019 <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY ❑ jECT LOC <br />GENERAL AGGREGATE <br />$ 2.000,000 r <br />GENL <br />X <br />PRODUCTS - COMPIOPAGG <br />$ S/TGen. Agg, <br />$ <br />OTHER <br />AUTOMOBILE LIABILITY <br />COMBINEDSINGLE LIMIT <br />ccde t <br />$ <br />_ <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />ALL OWNED -I SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accldent ) <br />$ <br />NON -OWNED <br />H IRED AUTOS _� AUTOS <br />PROPERTYDAMAGE <br />Per acnldant <br />$ <br />$ <br />UMBRELLA LIAOOCCUR <br />EACH OCCURRENCE <br />S <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />_J <br />CLAIMSTgAOE <br />OED RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY YIN <br />ANVPROPRIETORIPARTNERIEXEOUTIVE <br />EXCLUDED? <br />NIA <br />OTH• <br />ER <br />EACH T <br />$OFFICERIMEMBER <br />=ACCIDENT <br />MPLOYEE <br />$If <br />(Mandatory in NH) <br />yea, deacrlbe antler— <br />DESCRIPTIONOFOPERATIONSbDIow <br />ICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS I LOCATIONS (VEHICLES (ACORD fill, Additional Remade, Schedule, maybe attached If more apace Is required) <br />City of Santa Ana is listed as an Additional Insured. The Hlscox General Llability policy Is primary and any other Insurance maintained by the additional insured is excess and Non. <br />Contributory sabiect to the poiicy terms and condlhans, <br />y7 r'-^ <br />6^�-f 24R., F <br />City of Santa Ana <br />20 Civlo Center Plaza (Ni <br />P.O. Box 1088 <br />Santa Ana, CA 92702-19$8 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />9eAA-9ndd Aral Rrl rfOVM IDA-Finhl All .Ld,a.. ............I <br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />