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HUMAOPT-04
<br />CERTIFICATE OF LIABILITY INSURANCE I
<br />c,TEtMMroO"""'
<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 Ilou of such endorsamen a .
<br />PRODUCER License OS 24 ACT went
<br />Heffernan Insurance Brokers P"Alc°r', No.E,I: (949 771.3400 jAK, Ror(949) 771.3401
<br />15004 Sky Park Circle, Suite 210 -
<br />Irvino, CA 92614 LoMbh��ss
<br />INSURED
<br />Human Options
<br />P.O. Box 53745
<br />Irvine, CA 02619
<br />New York Marine 3 General
<br />rnvcverbce rPOTIPICATP NI IMRFR- O"Mi YN NI IMRCR.
<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 />WSR TYPE OF INSURANCE
<br />ADOLINSD
<br />SUER VANDI
<br />POLICY NUMBER
<br />POLICY
<br />EPF
<br />PCUCYEXP
<br />LIMITS
<br />A X
<br />I COMMERCIAL DEN:TtLL LAaaIn'
<br />cwA1s-MADE OCCUR
<br />X
<br />201901143
<br />912312019
<br />9123I2020
<br />__._
<br />EACH OCCURRENCE
<br />1,000,000
<br />DAMN iORENIu,
<br />LIEDEAP M ono
<br />500,000
<br />20.600
<br />PERSONAL E ADV INJURY
<br />3 1-0001000
<br />GENT AGGREGATE LIMIT AP PLIES PER
<br />POLICY ❑ a LOC
<br />OTHER:
<br />GENERAL AGGREGATE
<br />1 3,000,000
<br />PROD TS-COMPgP AGG
<br />3,000,000
<br />(SEXUAL MISCONOU
<br />1,000,000
<br />A
<br />I AVTOMOSILELMBILITY
<br />ANY AUTO _
<br />OVMEO - SCHEDULED
<br />AUTOS ONLY � AAUUTOSSµ�y
<br />X AtRTlS ONLY AUTOS ONLm Y
<br />201901143
<br />912312019
<br />9123=20
<br />COMBINED SINGLE LIMITwent
<br />1,000,00
<br />BODILY INJURY IPs, venorl-'
<br />BODILY INJURY ift accdoi
<br />PorOartlUanl MAGE !�
<br />A
<br />X
<br />UMBRELLA LMB X
<br />EXCESS LMB
<br />CcctXl
<br />CWNS-MADE
<br />201901143UMB
<br />912312019
<br />9I2L2020
<br />EACH OCCUR�IJCE IT5,000,000
<br />AGRREGATE
<br />5,000,000
<br />DED I X ' RETENTIONS 10,000
<br />B
<br />WORNERSC°MPENBATION
<br />IN° EMPLOYERS' LIABILITY
<br />ANPROPRIETOPPARTNERIEXECVTIVE
<br />OFFICE�N
<br />daMryENEp
<br />nn
<br />x'/ea deunea u,mer
<br />0 SCRIPTON F PERAT SnObn
<br />MIA
<br />C201900013809
<br />91112019
<br />91112029
<br />X I PiA RIME I TN -
<br />HCE
<br />1.000,000
<br />EL DISEASE - EA ELI OYE
<br />1.000,000
<br />E.L DISEASE -POLICYLIMIi
<br />1,000,000
<br />I
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101. Addlepnal Rit-ii SabadWa, may ba stul"d If mwa 1Paca 1. naubed)
<br />Re: As Per Contract or Agreement on File with the Insured.. CDBG
<br />City of Santa Ana, officers, agents, employees, and volunteers are named as additionally Insured on this policy pursuant to written contract, agreement, or
<br />memorandum of understanding are Included as additional Insureds (Primary and Non -Contributory) on the General Liability policy, per attached
<br />endorsement if required. Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation
<br />By Risk MdV1fIEv1F i Divis of.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana &0-OUTWORIZED
<br />!1a(oatCCOROANCE WITH THE POLICY PROVISIONS.
<br />Rlsk Management Division ,7 i L20 Civic Center PlazaSanta Ana. CA 92702 REPRESENTATIVE
<br />FRANCINE R. VILLARE L
<br />ACORD 25 (2016103) 9)1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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