Laserfiche WebLink
CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNWY) <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.I 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 INSURERS), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: It 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 Ileu of such endorsements . <br />PRODUCER <br />Arthur J. Gallagher & Co. NAME: Annie Lee _ <br />Insurance Brokers of CA., Inc. PHONE 505 N Brand Blvd, Suite 600 nidNO RM818.539.8601 I ia�yO1: 81a.5398701 <br />Glendale CA 91203 .ADDRESS. Annie Lee Sig.com _ <br />__ INSURE RIB) AFFORDING COVERAGE T <br />INSURED <br />Orange County Conservation Corps <br />1853 N. Raymond Ave. <br />Anaheim, CA 92801 <br />A <br />THIS IS TO CERTIFY THAT THE POLICIEi <br />INDICATED. NOTWITHSTANDING ANY R <br />CERTIFICATE MAY BE ISSUED OR MAY <br />EXCLUSIONS AND CONDITIONS OF SUCH <br />CLAIMS-MADEc Px] OCCUR <br />t^_I <br />I <br />G NILAGGREGATE LIMITAPPLIES PER: <br />%L POLICY L JEC J LOC <br />e 1 AUTOMOSILELIABILITY <br />X ANY AUTO <br />OWNED f1 SCHEDULED <br />HIRED <br />'i AUTOS ONLY i AUTOS <br />X_ AUTOS ONLY X NON NED <br />AUTOS <br />UTOSONLYY <br />X Comp$500 XI Coll $500 <br />A X - UMSRELLALIAG I XX 1 OCCUR <br />EXCESS LIAR I,.......... <br />al <br />AND <br />C DiredOrs & <br />NIT, TERM OR CONDITION OF ANY CONTRACT OR OTHER D <br />THE INSURANCE AFFORDED BY 'rHE POLICIES DESCRIBED <br />LIMITS SHOWN MAY HAVE BEEN-PDUCEO BY PAID CLAIMS. <br />Y I i PAC 5154680 15 <br />CAP 0991249 06 <br />UMB 560370515 <br />YIN J <br />NPU-WCG 001-2010 <br />LjINIAi <br />NY10DOLV03181NV <br />r WITH <br />IS SUE <br />42307 <br />'ECT TO WHICH THIS <br />TO ALL THE TERMS, <br />10/l/2019 <br />10/1/2020 <br />i EACH OCCURRENCE <br />` OAMAGTMcTiSREATErS—. - <br />PREMISES IEs acunange _ S <br />ME,EXP (Any one parson) 5 <br />PERSONAL&ADV INJURY $ <br />1 GENERAL AGGREGATE y <br />PRODUCTS -COMPIOPAGG $ <br />_ <br />s <br />10/1/2019 TOM12020 <br />COMBINE SIN LELMI <br />(Ea acdtlenll <br />}--5 <br />BODILY INJURY (Per person) $ <br />-.—._ <br />a00ILY INJURY (Per accleenQ+ S <br />I <br />PROPPER DAMAGE— $ <br />L <br />10/1/2019 10/1/2020 <br />�— <br />EACH OCCURRENCE <br />AGGREGATE $ <br />1/1/2019-=411V2020 . <br />A S <br />X Eft 1 OTH- <br />_ TATIITE i ER <br />10/1/2019 10/1/2020 <br />E.L. EACH ACCIDENT I s <br />DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES IACORD 101, Addltler.]Remarks SOhedwa, may bcaNached lr101e apace IS raq.1red) <br />Policy : Abuse and molestation <br />Policy #: PAC 5154680 15 <br />Carrier ;Great American Alliance Insurance Company <br />Policyy Term: 10/01/2019-10/0112020 <br />Per Claim:$1,000,000 ,Aggregate:$3,D0U,()0D <br />Policy : Professional Liability REVIEWMi ) & APPROVE D <br />Policy o PAC 515488015 f�y RI51C NACIEMENT DivISION <br />See Attached... <br />JHUULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana <br />SAMA HAM. EA bRDAiNCEIW THOHE POLHCY PROVISIONS.NOTICE WILL BE DELIVERED IN <br />Risk Management Division, 4th Floor <br />20 Civic Center Plaza AUTNORIZEDREP ESENTATIVE <br />Santa Ana CA 92702 " ,t <br />ACORD 25 (2016/03) The ACORD name and logo are' registered ,marks of ACORDORD CORPORATION. All rights reserve, <br />