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Francine R. aamn�n�.�wra�.bea
<br />w:o Villareal
<br />A� �® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE
<br />7/31/20)
<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 />CONTACT Yin i..
<br />NAME: 4 Q
<br />New Century Insurance Services
<br />License #OB0708$
<br />PHONE (626)300-9000 FAX (626)570-0908
<br />Ell AN No):
<br />-MAIL
<br />DRESS:
<br />INSURERS AFFORDING COVERAGE
<br />NAIC If
<br />16 N. 2nd Street
<br />INSURERA:Zurich American Insurance Company
<br />16535
<br />Alhambra, CA 91801
<br />INSURED
<br />INSURERB$artford Accident And Indemnity
<br />22357
<br />INSURERC.HiSCOX Insurance Company Inc
<br />10200
<br />Managed Career Solutions, SPC
<br />INSURERD12ravelers Casualtyand SuretyCo
<br />31194
<br />DBA: MICE Rehab & FTI-LA & American Medical Careers
<br />3333 Wilshire Blvd #405
<br />INSURER E:
<br />INSURERF:
<br />Los Angeles CA 90010
<br />COVERAGES CERTIFICATE NUMBER:CGL UME 20-21 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />T
<br />rypE OF INSURANCE
<br />ADDL
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIOD
<br />POLICY EXP
<br />MMIDD
<br />OMITS
<br />A
<br />R
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE FOCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TORENTED
<br />PREMISES Ea ocouman
<br />$ 100,000
<br />MED EX? (Any one person)
<br />$ 10,000
<br />$1,000 DED BI/PD
<br />R
<br />PRA 9314811-06
<br />7/1/2020
<br />„?_ 1,7/,2b21L>'
<br />per occurrence
<br />PERSONAL& ADV INJURY
<br />$ 1,000,000
<br />AGGREGATE LIMIT APPLIES PER.
<br />]PRO
<br />POLICY JECT � LOC
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEN'L
<br />X
<br />PRODUCTS-GOMP/OP AGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$
<br />1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />B
<br />X
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />X
<br />72UECRT9398
<br />7/7/2020
<br />7/7/2021
<br />BODILY INJURY (Per accent
<br />Pid
<br />( )
<br />$
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />PROPERTY DAMAGE
<br />Par accident
<br />$
<br />X
<br />UMBRELLA LIM
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />A
<br />EXCESS LIAe
<br />CLAIMS.MACE
<br />LIED
<br />RETENTION
<br />$
<br />Unm 0369817-00
<br />7/1/2020
<br />7/1/2021
<br />8
<br />WORKERS COMPENSATION
<br />ANDEMPLOYERS'LIABILIry YIN
<br />ANY PROPRIETOMPARTNEWEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED? El
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />Y
<br />72RECADOSO3
<br />7/1/2020
<br />7/1/2021
<br />p� PER OTH-
<br />STATUTE ER
<br />E.L EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 11000,000
<br />C
<br />PROF. LIAR: RETRO 1/11/2011
<br />11PL1601430.20
<br />7/25/2020
<br />7/25/2021
<br />REI-ENTION:$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 I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be 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 />Risk ganent
<br />lylidan
<br />Angela Lin/AGL REmEwED&APrRovEDBY.,
<br />©1988-2014ACORD 1
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Risk Manage
<br />mem AnalystINS025 ons4m f
<br />
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