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Francine R. aomw•s�s,r,..x,.a
<br />a°1p
<br />Villareal
<br />ACORO CERTIFICATE OF LIABILITY INSURANCE
<br />11%�
<br />DATE(MMIDO/YYYY)
<br />1 7/31/2020
<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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTAE: 9 QCT Yin iao
<br />AM
<br />New Century Insurance Services
<br />License #0207085
<br />Na. (626)300-9000 FAX (626)670-0908
<br />AC No:
<br />-MAIL
<br />ADDRESS:
<br />INSURERS AFFORDING COVERAGE
<br />NAIC tl
<br />16 N. 2nd Street
<br />INSURERA:Zurich American Insurance Company
<br />16535
<br />Alhambra, CA 91801
<br />INSURED
<br />INSURERB.Hart£ord Accident And Indemnity
<br />22357
<br />INSURERCOiSCOX Insurance Company Inc
<br />10200
<br />Managed Career Solutions, SPC
<br />INSURER DMravelers Casualty and Surety Cc
<br />31194
<br />DBA: MCS Rehab & FTI-LA & American Medical Careers
<br />INSURERE:
<br />3333 Wilshire Blvd #405
<br />LOB Angeles CA 90010
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER:CGL UMB 20-21 REVISION NUMB ---
<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 />ILTR NSR
<br />TYPE OF INSURANCE
<br />A D
<br />man
<br />5 BR
<br />wyn
<br />POLICY NUMBER
<br />MMNU EFF
<br />FOLIC EXP YYYI
<br />LIMITS
<br />A
<br />R
<br />COMMERCIALGENERAL LIABILITY
<br />CLAIMS -MADE � OCCUR
<br />URRENCE
<br />$ 1,000,000
<br />O RENTED Eao rnm
<br />$ 100,000
<br />$ 10,000
<br />$1,000 DED BI/PD
<br />R
<br />PRA 9314811-06
<br />7/1/2020
<br />`7 0't1�'nyanapenson)
<br />per occurrence
<br />&ADV INJURY
<br />U
<br />$ 1,000,000
<br />GEN'LAGGREGATE LIMIT APPLIES PER
<br />POLICY0JECT LOG
<br />AGGREGATE
<br />$ 2,000,000
<br />-COMP/OP AGO
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />N LE MIT
<br />Ea accident
<br />$ 1,000,000
<br />I
<br />BODILY INJURY (Per person)
<br />$
<br />E
<br />ANY AUTO
<br />ALLOWNEO SCHEDULED
<br />AUTOS AUTOS
<br />R
<br />72MCET9398
<br />7/7/2020
<br />7/7/2021
<br />BODILY INJURY Per accident
<br />( )
<br />$
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />PROPERTYDAMAGE
<br />Peraccident
<br />$
<br />X
<br />UMBRELLA LIM
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 1 000 000
<br />AGGREGATE
<br />$ 11000,000
<br />A
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />DEO I
<br />I RETENTION
<br />$
<br />UMB 0369817-00
<br />7/1/2020
<br />7/1/2021
<br />B
<br />WORKERS COMPENSATION
<br />ANDEMPLOYERS'LIABILITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE
<br />MFandatmy In NH FICERIMEMBER EXCLUDED'
<br />( ry )
<br />If Dyes, RIPTIOe under
<br />DESCRIPTION OF OPERATIONS below
<br />N/A
<br />Y
<br />72AECADDS03
<br />7/1/2020
<br />7/1/2021
<br />XI PER OTH-
<br />STATI7TE ER
<br />E.L EACH ACCIDENT
<br />$ 1 000 000
<br />E.L DISEASE - EA EMPLOYE
<br />$ 11000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 11000,000
<br />C
<br />PROF. LIAR: PETRO 1/11/2011
<br />MPL1601430.20
<br />7/25/2020
<br />7/25/2021
<br />RETENTION:$10,000; LIMIT 3,000,000
<br />D
<br />EMPLOYEE THEFT
<br />106547315
<br />7/1/2020
<br />7/1/2021
<br />RETENTION:$10,000; LIMIT 1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required)
<br />CITY OF SANTA ANA, OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS IS RESPECTED AS AN ADDITIONAL INSURED PER
<br />FORM CG 20 26 04 13 ATTACHED. SUCH INSURANCE IS PRIMARY AND NONCONTRIBUTORY PER UGL1327B ATTACHED. WAIVER
<br />OF SUBROGATION PER WC0403 ATTACHED. 10 DAYS NOTICE OF CANCELLATION FOR NONPAYMENT, 30 DAYS OTHERWISE.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE
<br />e. lEwED rlegormovEDefe.
<br />Angela Lin/AGL ����,��;-+�o��� REv1EWED&APPRDV®BY:
<br />©1988-2014ACORD 7mMsu I� F,,,� k. MA41!
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD sEssimm
<br />Risk Management Analyst
<br />INS025 r7n1ann _
<br />
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