Laserfiche WebLink
rd� CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMinq/YYYY) j <br />08/27/20t9 I <br />THIS CERTIFICATE IB 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 TI4E CERTIFICATE HOLDER. <br />7 MPORTANT: 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 polleles may require an endorsement. A statement on <br />this cortificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />_ <br />NAME: Certificate Issuance Team <br />Comprehensive Insurance Services <br />_ <br />PHONE (949) 709-6800 FA�(9Q9) 709-1668 <br />INC No' Ertl. AIC No . <br />26429 Rancho Parkway South <br />_ _ <br />E'M IL <br />ADDRESS; y�Ihocem jerem rehensiveinsurance,com <br />P <br />_ m INSURER S AFFORDING COVERAGE <br />NAIC k <br />Suite 120 <br />Lake Forest CA 92630 <br />INSURER A: Stale Compensation Insurance Fund <br />35076 <br />INSURED <br />INSURER a: <br />Orange County Chlldren's Therapeutic Ads Center <br />INSURER <br />INSURER B: ._�..��.._..v.�s®•�' <br />2215 N. Broadway <br />INSURER E: <br />_ _ <br />Santa Ana CA 92706 <br />COVERAGES CERTIFICATE NUMBER: WC REVISION NUMBER: <br />THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDA13OVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE ISSUED OR MAY PEREAIN, THE INSURANCE AFFORDED BYTHE 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 />INTR <br />TYPE OF INSURANCE <br />DBI <br />Mp <br />BUTTA <br />VLVq <br />POLICYNUMHER <br />'G YEFF <br />MAilOgIYYYYI <br />PULICYEXP <br />fMM1DDttYYY1 <br />LIMITS <br />COMMERCIAL GENERAL LIABILITYvy <br />—11 I I <br />CLAIMS -MADE 4__J OCCUR <br />EAOI I OCCURRENCE <br />�w _ <br />$ <br />A A <br />RP EMfI5E51Ea aacurrencal <br />Ei <br />MED EX?(AnXonopersnn <br />5 <br />PERSONAL a ADV INJURY <br />$ <br />GENERALAGGREGATE <br />---- _ <br />g <br />GENT <br />AGORE4;A# G LIMIT APPLIES PER: <br />policy ClP[CT LOC <br />_ <br />PRODUCTS - COMPIOP AGO <br />.6 <br />AUTOMOBILE <br />LIABILITY <br />CObiliff SIR1GLELIMIT <br />E.l Ildd dM g���� <br />BODILY INJURY (Per parson) <br />It <br />ANYAUTO <br />OWNED SCHEDULED <br />AUTOS ONLY _ AUTO 9 <br />BODILY INJURY(For accidem) <br />$ <br />PRtfl pE#i#Y 1)AM9iiF <br />P r mradenl � <br />$' <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />_ <br />$ <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />_ <br />AGGREGATE <br />_ <br />$ �w —^— <br />EXCESS LIAB <br />CLAIMS -MADE <br />_.._ T <br />�y <br />A <br />RED RETEN110N $ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNERIEXECUUVE <br />OPFICERIMEMBER EXCLUDEDP <br />(MandalaryinNH) <br />NIA <br />)� <br />9255171-2019 <br />O6/05/2019 <br />O6l0512D20 <br />__ <br />X vTA y?F_ FfiH <br />EL EcgI-IACGIO ENT <br />$ 1,000,000� <br />-.-- <br />EL DISEASEEAEMPLOYEE <br />- <br />g 1-0001000 <br />If,os, deecrm. mmsr <br />DESCRIPTION OF OPERATIONS onto, <br />E.L.. DISEASE -POLICY LIMIr <br />$ 1,000,000 <br />®.._.1_..�._ <br />_ <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addolanal Romorks Schedule, may be attached if morn space Is required) <br />The City of Santa Ana, !Is officers, employees, agents, and representatives. 30 day notice of cancellation with 10 day notice of cancellation for non-payment <br />of premium per policy provision. <br />REVIEWED & APPROVED <br />By RiSI( MANAGEMENT DIVISION <br />_>sspp.,_0. <br />City of Santa Ana <br />Risk Mangement Division <br />20 Civic Center Plaza 41h FI. <br />Santa Ana <br />CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBEDIFFOI IGUED d6-DANCCL4: <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />tc) 19U8,2U15 ACUKD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />