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HUMAN OPTIONS, INC.
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Last modified
3/26/2024 9:15:18 AM
Creation date
7/21/2020 10:09:35 AM
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Contracts
Company Name
HUMAN OPTIONS, INC.
Contract #
A-2020-043-12
Agency
COMMUNITY DEVELOPMENT
Council Approval Date
3/3/2020
Destruction Year
2027
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Francine R. Dl9ltally signed by <br />Francine R. Villareal <br />Villareal Date2020,11.1016:23:58 <br />4H300' <br />A� D® CERTIFICATE OF LIABILITY INSURANCE <br />DATsrz3aaae <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 endorsement(s). <br />PRODUCER <br />(OC) Heffernan Insurance Brokers <br />18004 Sky Park Circle, Suite 210 <br />Irvine CA 92614 <br />CONTACT <br />NAME: <br />PHONE g49 771-3400 FAX No:949-771-3401 <br />E-MAIL <br />ADDRESS: <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURERA: Nonprofits Insurance Alliance of California <br />1184 <br />License#' 0564249 <br />INSURED HUMAOPT-04 <br />Human Options, Inc. <br />PO Box 53745 <br />INSURER B: New York Marne $ General Insurance Company <br />16608 <br />INSURER C: Lloyd's of London <br />INsuRER D: <br />Irvine CA 92619 <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 1803094784 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 />LTR <br />OF INSURANCE <br />ADOLTYPE <br />JIM <br />wyl SUBR <br />POLICYNUMBER <br />MMIDO EFF <br />MMIDD POLICY UP <br />A <br />X <br />COMMERCIAL GENERAL ABILITY <br />V <br />202013343 <br />9/23/2020 <br />9/23/2027 <br />.EACH OCCURRENCE <br />$1,90G,000 <br />CLAIMS -MADE I X1 OCCUR <br />DA A ET RENTED <br />PREMISES Eaoocuaence <br />$500,000 <br />MED UP (My one person) <br />$20,000 <br />PERSONAL B ADV INJURY <br />$1,000.000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERALAGGREGATE <br />$3.000.000 <br />POLICY PR0- � <br />ECT LOC <br />PRODUCTS -COMPMP AGG <br />$3.000,000 <br />Sexual Misconduct <br />$1,000,000 <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />202013343 <br />9/23/2020 <br />9/23/2021 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />g1800004 <br />BODILY INJURY (Per pamon) <br />$ <br />ANYAUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Par nodded) <br />$ <br />X <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />$ <br />A <br />X <br />UMBRELLALIAB <br />X <br />OCCUR <br />202001143UMB <br />9/23/2020 <br />9/23/2021 <br />EACH OCCURRENCE <br />$5,G00,0o0 <br />AGGREGATE <br />$5,000,000 <br />EXCESS LIAR <br />CLAIMS -MADE <br />DEO I X I RETENTION$ It <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILRY YIN <br />WC202000013809 <br />4/1/2020 <br />4RP2621 <br />X PER I OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />ANYPROPRIETOR/PARTNEWEXECUTNE <br />RIM OFFICEEMBEREXCLUDED9 ❑ <br />NIA <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />(Mandatory In NH) <br />If yes, descnba under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1.000.000 <br />C <br />Cyber Uaglity <br />ES10119140663 <br />6/20/2020 <br />9/23/2021 <br />Limit <br />1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Re: Services at the Santa Ana Police Department's Family Justice Center. The City of Santa Ana, its officers and employees are included as an additional <br />insured on General Liability policy per the attached endorsement, if required. <br />Certificate of Instrarroe shall provide thirty (30) day prior Written nodoe of Cancellation <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza 4th floor <br />Santa Ana CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED <br />©1988.2015 ACORD CO <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />Ride Mrsnagnnent Divf sian <br />rREmEWED Is APPROVED By., <br />0_4.11#L11.IPJ-z' rb6HlM�e ram. VaRRE/t¢bl. <br />® Risk Management Analyst <br />
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