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BARBOZA & ASSOCIATES
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Entry Properties
Last modified
8/8/2024 3:57:32 PM
Creation date
7/16/2021 11:22:17 AM
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Contracts
Company Name
BARBOZA & ASSOCIATES
Contract #
N-2021-149
Agency
Human Resources
Expiration Date
7/7/2022
Insurance Exp Date
5/1/2025
Destruction Year
2027
Notes
For Insurance Exp. Date see Notice of Compliance
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�� CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD/YYYY) <br />7/19/2021 <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 have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />NAME: <br />COMPLETE EQUITY MARKETS INC <br />a//C°NN Ext: 847 541-0900 a/c No: 847 541-0444 <br />A RIESS: <br />1190 Flex Court <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />Lake Zurich, IL 60047 <br />INSURERA: Underwriters at Lloyd's London <br />INSURED <br />INSURER B <br />Barboza & Associates, A.L.C. <br />INSURER C <br />INSURER D7 <br />660 S. Figueroa St. #1620 <br />INSURERE: <br />Los Anqeles, CA 90017 <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 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 />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM/DD/YYYY <br />POLICY EXP <br />MM/DD/YYYY <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />DAMAGE TO RENTED <br />CLAIMS -MADE 1:1OCCUR <br />PREMISES(E. occurr,ence)$ <br />MED EXP (Any one person) <br />$ <br />PERSONAL & ADV INJURY <br />$ <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ <br />POLICY ❑PRO ❑ LOC <br />JECT <br />PRODUCTS - COMP/OP AGG <br />$ <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />PER OTH- <br />STATUTE ER <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. EACH ACCIDENT <br />$ <br />OFFICER/MEMBER EXCLUDED? ❑ <br />N/A <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />A <br />Professional Liability <br />X <br />672951 <br />5/1/2021 <br />5/1/2022 <br />Each Claim <br />$1,000,000 <br />Aggregate <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Subject to all policy terms, conditions, exclusions and endorsements. The City of Santa Ana, its officers, officials, <br />employees and volunteers are listed as an additional insured with a 30 day notice of cancellation but only per the terms & <br />conditions of the endorsement generated and subject to all policy terms, conditions, exclusions, and endorsements. <br />CERTIFICATE HOLDER CANCELLATION <br />The City of Santa Ana, its officers, officials, employees and volunteers <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <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 PROVISI^"'C <br />Risk Mrutgentent Division <br />AUTHORIZED REPRESENTATIVE REVIEWED&APPROVED BY: <br />`9JIiilJlF•�L' �-r.�:e �iGelia�io <br />P, Risk Management Specialist <br />© 1988-2015 ACORD <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />
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