SOUTHLAND fka ENVISE - Laserfiche WebLink

Home Browse Search

Digitally signed by Francine R. .., Francine R. Villareal Dllareal ,4�o�Fro® CERTIFICATE OF LIABILITY INSURANCE DATE AT (MMID21wn THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Artex Risk Solutions, Inc. 2850 Golf Road, 5th Floor CONTACT NAME: Sheryl Haas PHONE . 630-285-4187 ac No: No Eau Rolling Meadows IL 60008 EAic. -MAIL ADOREss: Sheryl haas@artexrisk.com INSURERS AFFORDING COVERAGE NAIC4 INSURER A: Old Republic Insurance Company 24147 INSURED Envlse INSURERS: Lexington Insurance Company 19437 12131 Western Avenue INSURERC: IxsURER O: Garden Grove, CA 92841 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 548131216 REVISION NUMBER - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADOLSUBR MYJ2 POLICY NUMBER POLICY EFF (MMIDDVYYYyl POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR MWZY30720420 4/1/2020 4/1/2021 EACH OCCURRENCE $1.000,000 DAMAGE? RENTED PREMISESSEa occurrence $100,000 X MED EXP (Any y one person) $10,000 Contractual Liab PERSONAL B ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY JEC LOC PRODUCTS - COMP/OP AGG $2.000,000 $ OTHER A AUTOMOBILE LIABILITY MWTB30717720 4/1/2020 4/1/2021 COMBINED SINGLE LIMIT Ea accident $2.000,000 X BODILY I NJ URY(Par person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Par eccitlenl ) $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ B X UMBRELLALIAB X OCCUR 023627653 4/1/2020 4/1/2021 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000.000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$ 1. runn $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN MWC 30717620 4/1/2020 4/1/2021 X S?ATUTE �RH EL EACH ACCIDENT $1.000.000 ANYPROPRIETOWPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) It yes, describe under E.L. DISEASE -POLICY LIMIT $1,000.000 DESCRIPTION OF OPERATIONS below A Auto Physical Damage MVVTB30717720 4/1/2020 4/1/2021 Camp DeE: $250 Collision Ded: $500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached it more space is required) RE: All Operations Envise SoCal The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and representatives are named as additional insured ("additional insured") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and noncontributory. Thirty (30) days notice of cancellation applies. City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE g yeRIAMvugemnit Dhiiii �rc`REVIEW a^' ED&APPRUVEDBr. m Fels-*cLa.4 R. V:Uti,�L( ® Risk Management Analyst