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Francine R. o'reaa�we.a
<br />Villareal
<br />`4� a CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM)ODFYYWI
<br />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(les) 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 Ileu of such endorsement(s).
<br />PRODUCER
<br />CONEACT Ying Qiao
<br />New Century Insurance Services
<br />PHONE (626)300-9000 FAC (6267570-090e
<br />License #OBO7085
<br />EMAIL
<br />ADPHESS,
<br />16 N. 2nd Street
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC9
<br />Alhambra, CA 91801
<br />INSURERA:Zurich American Insurance Company
<br />16535
<br />INSURED
<br />INSURER B Eartford Accident And Indemnit
<br />22357
<br />Managed Career Solutions, SPC
<br />INSURERC-HiSCOX Insurance ComPany Inc
<br />10200
<br />DBA: INCH Rehab & FTI-LA & American Medical Careers
<br />NSURERO Travelers Casualty and Surety Co
<br />31194
<br />3333 Wilshire Blvd #405
<br />INSURER E:
<br />Los Angeles CA 90010
<br />INSURERF:
<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 />iLIRR
<br />TYPEOFINSURANCE
<br />AGD
<br />UB
<br />POLICYNUMBER
<br />M DD EFF
<br />POLICY
<br />IO�YW
<br />LIMBS
<br />ACLAIMS-MADE
<br />MMERCIAL GENERAL LIABILITYEACH
<br />® OCCUR
<br />4801,000
<br />OCCURRENCE
<br />$ 1,000,000
<br />AG NTED
<br />s 100,000
<br />g 10,000
<br />DED BI/PD
<br />X
<br />PRA 9314811-06
<br />7/1/2020
<br />,'-f, �R2=
<br />MED EXP (any we person)
<br />per occurrence
<br />PERSONAL SADV INJURY
<br />$ 11000,000
<br />AGGREGATE LIMIT APPLIES PER
<br />POLICY ❑PRO ❑ LOC
<br />JECT
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />OWL
<br />X
<br />PRODUCTS. COMPIOP AGG
<br />$ 2,000,000
<br />$
<br />OTHER
<br />OBILE LIABILITY
<br />COMBINEDLIMITdsou
<br />$ 31000,000
<br />BY
<br />FFMREDA
<br />AND
<br />L OWNED SCHEDULEDITOEAUTOS
<br />X
<br />72DECRT9399
<br />7/7/2020
<br />7/7/2021
<br />BODILY INJURY (Per person)
<br />$
<br />BOOILYINJURV (Par eccidn0
<br />8UTOS
<br />NON -OWNED
<br />AUTOS
<br />PROPERTY DAMAGE
<br />Per accident)$
<br />8
<br />A
<br />X
<br />UMBRELLALIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />EACH OCCURRENCE
<br />$ 11000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />0 D
<br />RETE O S
<br />$
<br />Olds0369817-00
<br />7/1/2020
<br />7/1/2021
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE
<br />(M ndamn; in NH) EXCLUDED?OFFICERIMEMBER
<br />IFyyees, deaelkle antler
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />Y
<br />72WECADOS03
<br />7/1/2020
<br />7/1/2021
<br />X PER OTH-
<br />ETA E
<br />E.L. EACH ACCIDENT
<br />$ 1 000 000
<br />EL DISEASE -EA EMPLOYE
<br />$ 1,000 000
<br />EL DISEASE - POLICY LIMIT
<br />S 11000,000
<br />C
<br />PROF. LIAB: RETRO 1/11/2011
<br />HPL1601430.20
<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 11000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe aftachad 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 />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702
<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 />Lin/AGL
<br />®1988.2014
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />INS025 anlann
<br />��F.- RJalcManogelluJlEDivGlmt 'Y?
<br />REVIEM& APPRoVEr, Sr,
<br />F4r e;..2 P, If+y: ,4
<br />Risk Management Analyst
<br />
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