|
i^1 COMMLEG-01
<br />.4CORO CERTIFICATE OF LIABILITY INSURANCE
<br />DAT/30/2020
<br />W30/2020
<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 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 endorsemen s .
<br />PRODUCER License if OC32169
<br />Rancho Mesa Insurance Services, Inc.
<br />250 Riverview Parkway
<br />Santee, CA 92071
<br />C ACT
<br />PHONE FAX
<br />A/c NP. E.tj_(619) 937-0164 tAIC No : 619 937-0168
<br />"I
<br />INSURERISI AFFORDING COVERAGE
<br />INSURER A Arch Insurance Company
<br />11150
<br />INSURED
<br />Community Legal Aid SoCat
<br />2101 North Tustin Avenue
<br />Santa Ana, CA 92705
<br />INSURER a New York Marine & Gen'l Ins Co
<br />10600
<br />INSURER C
<br />INSURER D
<br />— -'—
<br />INNSURE E
<br />URER F:
<br />COVERAGES CERTIFICATE NUMBER: 1 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 />TYPE OF INSURANCE
<br />ADDL
<br />INqQ
<br />SUER
<br />Mn
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY UPJLDL
<br />LIMITS
<br />A
<br />X
<br />I COMMERCIAL GENERAL UABIIJTY
<br />CLAIMS -MADE QX OCCUR
<br />X
<br />AAPKGO046502
<br />-
<br />71112020
<br />71112021
<br />EACH OCCURRENCE_1,000,000
<br />=AMA T1EREAMEDa
<br />1,000,00g
<br />M D UP (My es �
<br />25,000
<br />PERSONAL & ACV INJURY
<br />S 1,000,000
<br />NL AGGRE LIMIT APPLIES PER.GENERALA
<br />POLICY �JPR Lac
<br />OTHER
<br />ft
<br />21000,000
<br />PRODUCTS- P
<br />21000,000
<br />A
<br />AUTOMOBILE LIABILITY
<br />OWNED SCHEDULED
<br />IxANYAUTO
<br />AU�RTEO�S ONLY NApUTryOpS E
<br />HAUTOS ONLY X AUTOS NL�
<br />PKGO046502
<br />71112020
<br />711/2021
<br />COMBINED SINGLE LIMIT
<br />1,00,006
<br />BODILY INJURY Pe,
<br />BODILY INJURY Per
<br />0
<br />A
<br />X
<br />UNaRPJ.lA LU1B
<br />EXCESS LIAR
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />FXS0046502
<br />71112020
<br />71112021
<br />R E
<br />3,000,000
<br />AGGREGATE3,000,000
<br />DED X RETEWONS D
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY y/N
<br />ANY PROPRIETOMPARTNEWE%ECUTNE ❑
<br />WpoFFICEtLMEMBEpp EXCLUDED?
<br />.F"CEIIXY In KNI
<br />r . C PTIONN F
<br />RIPT FLIMIT,
<br />NIA
<br />C201900015159
<br />91112019
<br />�/
<br />g/1YLO�B
<br />,/E.L
<br />1( PERTIrMSTA DTI}
<br />EACH ACCIDENT
<br />s 1,ggg,gBB
<br />DI
<br />1,000,000
<br />_
<br />1,00g,000
<br />A
<br />Abuse & Molestation ✓
<br />PKGO046502
<br />71112020
<br />71112021
<br />Aggregate
<br />2,000,000
<br />DEWRIPnMO OPERAnONSILOCATIONSIWHICLES ACORDIOI.AdMonaiRenu sSche 0*,M as ch"Wl s"cels ulM
<br />RE: OPERATIONS OF THE NAMED INSUREDA CERTIFICATE HOLDERS INTEREST�MAY APPEAR SUBJECT10 POLICY TERMS,
<br />CONDITIONS, AND EXCLUSIONS. City of Santa Ana, officers, agents, employees, and volunteers are named as additionally Insured on this policy pursuant to
<br />written contract, agreement, or memorandum of understanding. Such Insurance as is afforded by this policy shall be primary, and any Insurance carried by
<br />City shall be excess and noncontributory. ✓
<br />CERTIFICATE HOLDER
<br />/
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />CITY OF SANTA ANA ✓
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />RISK MANAGEMENT DIVISION
<br />20 CIVIC CENTER PLAZA
<br />—
<br />AUTHORIZED REPRESENTATIVE
<br />SANTA ANA, CA 92701
<br />ACORD 25 (2016103) B 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
|