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Francine R.
<br />Villareal
<br />Alls� Ro ® CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIDDIYYYY)
<br />./�L/LULU
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
<br />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 rec ulre an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endcrsement(s).
<br />PRODUCER
<br />CAME CT Ying Qiao
<br />New Century Insurance Services
<br />Esn.PHONE (626)300-9000 FAX
<br />License #OB07085
<br />Na:(,as)570-09D8
<br />E-MAIL
<br />ADDRESS,
<br />16 N. 2nd Street
<br />INSURERS AFFORDING COVERAGE
<br />NAIL%
<br />Alhambra, CA 91801
<br />INSURERA:Zurich American Insurance Company
<br />16535
<br />INSURED
<br />INSURER B Hartford Accident And Indemnity
<br />22357
<br />Managed Career Solutions, SPC
<br />INSURERCEiscoz Insurance Company Inc
<br />10200
<br />DBA: MCS Rehab 6 FTI-LA & American Medical Careers
<br />MSURERDTravelers Casualty and Surety Co
<br />31194
<br />3333 Wilshire Blvd #405
<br />INSURER E: _
<br />Los Angeles CA 90010
<br />INSURER F:
<br />u��w,vo nvral�CR:
<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 OFSUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILTR
<br />TYPE OF INSURANCE
<br />AO
<br />eR
<br />POLICY NUMBER
<br />MOIDD EFF
<br />M1%U1YEX1
<br />ryyyry
<br />LIMITS
<br />A
<br />X
<br />COMMERCIALGENERALLIABILITY
<br />CLAIMS -MADE ❑X OCCUR
<br />EACH OCCURRENCE
<br />$ 1, 000,000
<br />PREMISE Eaapmw c
<br />S 100,000
<br />�1,000 DED BI/PD
<br />R
<br />PRA 9314811-06
<br />7/1/2020
<br />_?/ f1�4`-'
<br />MEO EXP(Any one Person)$
<br />10,000
<br />Per occurrence
<br />PERSONAL&ADV INJURY
<br />$ 1,000,000
<br />AGGREGATE LIMIT APPLIES PER
<br />POLICY ❑°Eej LOC
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEWL
<br />X
<br />PRODUCTS-COWIOPAGG
<br />$ 2,OOD,000
<br />OTHER:
<br />$
<br />E
<br />AUTOMOBILE
<br />n
<br />LIABILITY
<br />ANY AUTO
<br />ALLOWNED SCHEDULED
<br />AUTOS AUTOS
<br />HIRED AUTOS NON -OWNED
<br />AUTOS
<br />X
<br />72DE=9398
<br />7/7/2020
<br />7/7/2021
<br />COMBINED SI il
<br />$ 1,000,000
<br />BODILY INJURY (Per Person)
<br />$
<br />BODILY INJURY (Par acnident)
<br />8
<br />PPROar PPEERTY DAMAGE cddantl
<br />$
<br />$
<br />A
<br />X
<br />4EACH
<br />UMBRELLALIAS
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -NUDE
<br />UMB 0369817-00
<br />7/1/2020
<br />7/1/2021
<br />OCCURRENCE
<br />$ 11000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />DEO
<br />10 $
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANYPROPRIETOMPARTNEWEXECUTIVE
<br />OFRCERIMEMBER EXCLUDED?
<br />(Mandatory In NH)
<br />NYes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />Y
<br />72NECAnOSO3
<br />7/1/2020
<br />7/1/2021
<br />PER E ERry-
<br />g ftjffiff
<br />E.L.EACH ACCIDENT
<br />$ 1,000,000
<br />EL DISEASE - EA EMPLO
<br />$ 1,000,000
<br />EL DISEASE -POLICY LIMIT $ 1 000 000
<br />C
<br />D I
<br />PROF. LIAB: RETAO 1/11/2011
<br />EMPLOYEE THEFT
<br />MPL1601430.20
<br />106547315
<br />7/25/2020
<br />7/1/2020
<br />7/25/2021
<br />7/1/2021
<br />RETENTION:$10,000; LIMIT 3,000,000
<br />RETENTION:810,000: LIMIT 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES (ACORD 101, AddiRonal Remarks Schedule, maybe aaached If more apace 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 ATTACKED. 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 />ACORD 25 (2014101)
<br />INSO25 tmia111
<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 />Lin/AGL
<br />©1988.2014 AC(
<br />The ACORD name and logo are registered marks of ACORD
<br />�e=_.?a RlrkhlvvgangdlTreiaNlL
<br />,y 4 (REVIEWED&IA7PPP'`R`,O'IVEo
<br />t I
<br />? a r4kiY.:.h2 Tom. WUM4.G
<br />Risk ManagemenAnalyst
<br />
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