|
WISECAC-C1
<br />AYNE
<br />aC7"rty CERTIFICATE OF LIABILITY INSURANCE
<br />D07`30/2019
<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 />_
<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, cortain 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
<br />Bolton & Comppany
<br />E, Foothill Blvd., Suite 900
<br />C ACT
<br />PHONEFAX
<br />Ext: (626) 799-7000 I No, No :(626) 441.3233
<br />'_g ss: Propcasual holt0n0o.com m
<br />3476
<br />Pasadena, CA 91147
<br />INSURERISI AFFORDING COV@¢[��
<br />NAIL N
<br />INsuRER A: PhiladalDhia Insurance Conn amt
<br />�16608
<br />23880
<br />INSURED
<br />INSURER a: NewYarkMarine&Ganarallns.Co.
<br />INSURERC:
<br />Wiseplace, CA Corp. Wise Silver Center coa:
<br />INSURER D:
<br />1411 N. Broadway
<br />Santa Ana, CA 92706
<br />INSSURER 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 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 />TYPEOFINSURANCE
<br />ADDL im
<br />yyuBp
<br />POLICY NUMBER
<br />P&MY EFF
<br />POLTCY EXP
<br />LIMITS
<br />A
<br />X
<br />I COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />X
<br />PHPK1924744
<br />01/01/2019
<br />01101/2020
<br />EACH OCCURRENCE
<br />DAMAGETORENTEo e
<br />s 1,000,000
<br />$ 100,000
<br />MED EXP An axle ersgi
<br />$ 6'000
<br />PERSONAL&ACV INJURY
<br />S 1,000,000
<br />_
<br />N'LA6GREGATEUMI'r APPL $PERT
<br />POLICY LOG
<br />ERAL AGGRE TE
<br />PRODUCTS-COMPIOPAGG
<br />2,000,000
<br />2000000
<br />Or ER:
<br />SEXUAL PHYSICAL
<br />$ 1,000,000
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />Ea eolddeD{SINGLELIMrr
<br />1,000,000
<br />ANY AUTO
<br />PHPKI924744
<br />01/01/2019
<br />01/0112020
<br />e OILY INJURY Per arson
<br />BODILY INJURY fleer acrlderrt
<br />S
<br />_
<br />AO TU OWNEDEEp�
<br />AUT0.SULEO
<br />POr aPcER AMAGE
<br />iAOS
<br />-_-��
<br />X
<br />X..
<br />ONLY OpOWW
<br />A
<br />X
<br />UMSREWAUAD X OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />EXCESS LIAS CI-NMS-MADE
<br />PHUB660328
<br />01/01/2019
<br />01/01)2020
<br />AGGREGATE
<br />S
<br />DED I X RETENTION$ 10,000
<br />Aggregate
<br />1,Oo0,000
<br />p
<br />B
<br />WORKERS COMPENSATION
<br />ANDEMPLOYERVLIABILITY YIN A
<br />ANY PROPMETORPARTNFR,EXECUTIVE
<br />pFFICEpp>M MBER FXCLUpEC4 �_I
<br />Mandakory�e NH)
<br />If yyes, describe under
<br />DESCRI T N F PERATI NSbelmv
<br />NIA'
<br />��
<br />0201800006833
<br />0811612019
<br />08/15/2020
<br />TER T OTH-
<br />E_L.EACHACCIOENT _
<br />- MPLOYE
<br />EL. .DISEASE-P ICY UNIT
<br />1,000,000
<br />11000,000
<br />$ 1,000,000
<br />A
<br />lProfessional Liabili
<br />PHPKI924744
<br />01101/2019
<br />0110112020
<br />A
<br />Crime
<br />PHPKI924744
<br />0110112019
<br />01/0112020
<br />DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES (ACORD 101, Additlonei Remarks Sebedule, may be aaechod It Mura apace N requiredi
<br />GL Additional Insured applies per OG20130413 attached, only if required by written contractfagreement
<br />Primary and Non -Contributory Wording applies per PIGL0050712 attached,
<br />Notice of Cancellation applies per IL00171198 attached,
<br />Additional Insured($): Cify of Santa Ana, its officers, employees, agents, volunteers and representatives.
<br />RE: Operations of the named Insured,
<br />Law�><a�2lil.i
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana y� THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Rity f Santa Ana Division ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza, 4th -
<br />Santa Ana, CA 92701 AMAN !A My LAMBERT AUTHORIZED REPRCSCNTATIVE
<br />h,ryd.•,
<br />ACORD 26 (2016103) O 1988-2/0115 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
|