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Last modified
4/23/2021 4:11:30 PM
Creation date
6/21/2019 10:31:41 AM
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Template:
Contracts
Company Name
OC HUMAN RELATIONS
Contract #
N-2019-105
Agency
PLANNING & BUILDING
Expiration Date
5/23/2020
Insurance Exp Date
4/26/2021
Destruction Year
2025
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--oss1 OCHUMAN-01 <br />TGARRISON <br />DATE IMMIDDIYYYYI <br />6/2212020 <br />ACORQ CERTIFICATE OF LIABILITY INSURANCE <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 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 endorsements . <br />PRODUCER <br />c TACT Laura Hicks <br />Schweickert & Company Insurance Agents, Brokers 3 Managers <br />17300 Red Hill Avenue, Suite 210 <br />Irvine, CA 92614 <br />PHONE FAX <br />ac. No, Eat : ac, No): <br />I . ]aura schweickert.com <br />INSURERS AFFORDING COVERAGE <br />NAIC a <br />INSURER A:Philadelphia lnsuranceCom an <br />18058 <br />INSURED <br />INSURER B : Lloyd . a Of London <br />INSURERC: <br />OC Human Relations Council <br />INsuRER o <br />1801 E Edinger Ave, Suite 115 <br />Santa Ana, CA 92705 <br />INSURER E <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 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 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 />ADDLJITJL <br />SUBR <br />POLICYNUMBER <br />POLICY EFF <br />POLICY E%PWVD <br />IMWDDINYYYI <br />LIMITS <br />A <br />X <br />COMMERCIALGENERALUABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />CLAIMS -MADE OCCUR <br />X <br />PHPK2126137 <br />4I26I2020 <br />M26I2021 <br />DAMAGE TO RES IE,ENTEDREM <br />100,000 <br />X <br />MED EXP An one n <br />5,000 <br />Sex Misc/Prof Lia <br />B <br />X <br />Cyber$1,000,000 <br />1D4B1180301 <br />12/15/2019 <br />12/15/2020 <br />PERSONA sADV INJURY <br />1,000,000 <br />GEN'L AGGREGATE URMpIT. APPLIES PER. <br />X POLICY O JEGT LOC <br />GENERAL AGGREGATE <br />f 2,000,000 <br />PRODUCTS - COMPIOP AGO <br />2,000,000 <br />Deductible <br />S 0 <br />OTHER: <br />A <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />1,000,000 <br />BODILY INJURY Per ppreom <br />S <br />ANY AUTO <br />PHPK2126137 <br />412612020 <br />4/2612021 <br />BODILY INJURY Per t <br />S <br />AUpT�C�SOONLY SCHEDULED <br />Pm awEant AMAGE <br />$ <br />Ix ALTOS ONLY X AUTOS ONLY <br />Deductible <br />S 0 <br />UMBRELLA LUIB <br />OCCUR <br />EACH OCCURRENCE <br />S <br />AGGREGATE <br />$ <br />EXCESS UAR <br />CLAIMS -MADE <br />DED I I RETENTIONS <br />S <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIFTORIPARTNERMXECUTIVE ❑ <br />��FFILER/MEM"' EXCLUDED? <br />(Mandatory In NN) <br />NIA <br />PER OTH- <br />STA <br />EL EACH ACCIDENT <br />3 <br />E.L DISEASE -EA EMPLOYE <br />$ <br />E.1- DISEASE -POLICY UMIT <br />S <br />11 yea. deecdbe under <br />DESCRIPTION OF OPERATIONSbelm <br />A <br />Property <br />PHPK2126137 <br />4/2612020 <br />4/2612021 <br />Ded $500 <br />70,000 <br />A <br />Property <br />PHPK2126137 <br />4126/2020 <br />412612021 <br />Ded $1000 <br />100,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES IACORD 1e1, AddlUmwl Remarks Schedule, maybe seethed %more space Is required) <br />City of Santa Ana, its officers, employees, agents and representatives are named as Additional Insured with respects to the operations of the Named Insured. <br />Policy will be primary and not contributory with respect to insurance or self-insurance programs maintained by the City and contains standard separation of <br />insureds provisions with respects to providing conflict resolution training and support. Policy shall not be cancelled or reduced in coverage or changed in <br />any other material aspect without thirty (30) prior written notice to the City, (end date - December 31, 2020) <br />RgE RIEk E p & MPPRENTpO S OD <br />City of Santa Ana <br />Risk Management DivisionFRA <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana, CA 92701 <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 />�Ga <br />- m � <br />ACORD 25 (2016103) 0 1988-2u15 ACUKU UUKI-VKA I IUN. An ngnrs reserves. <br />The ACORD name and logo are registered marks of ACORD <br />
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