TALLER SAN JOSE HOPE BUILDERS (7)

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A� br CERTIFICATE OF LIABILITY INSURANCE OATE(MMIDDYYYY) 0810512020 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 Marsh USA Inc. 13015th Avenue, Suite 1900 Seattle, WA 98101 ABm Jennifer Caudebec-206-214-3156 CONTACT NAME: lAnd No Exit- PHONE A/C No: E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE - NAIC If INSURER A: Safety National Casualty Corp. 15105 CNI 18985706�00000�XSWG19-22 INSURED Providence St. Joseph Health INSURER B:' INSURER C Slaters of St. Joseph Of Orange - 1801 Lind Ave SW #9016 Renton, WA 98057-9016 - INSURER D: INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: SEA-003556843-09 REVISION NUMBER: 7 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. HER LTR TYPE OF INSURANCE ADDL SUBR POLICYNUMBER POLICY BEE POLIMM1DD/YEYY LIMITS COMMERCIAL GENERAL LABILITY CLAIMS -MADE ❑OCCUR EACH OCCURRENCE Is DAMAGE TO RENTED - PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL &ADV INJURY Is GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PECT RO ❑ LOC J OTHER: GENERALAGGREGATE Is PRODUCTS - COMPIOP AGO $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea ercl $ BODILY INJURY (Per person) $ BODILY INJURY(Peraccldorau $ PROPERTYDAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DIED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNEWEXECUTIVE OFFICIMMEMBEREXCLUDE09 (Mandatory In NH) Use describe under DESCRIPTION OF OPERATIONS below NIA SP4059664 SIR: $2,000,000 0 (012 0110112022 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE -POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required) SSJO doe Taller San Jose, Block Grant, SIO N. Poinaetta, Santa Ana, CA 92701. City of Santa Ana, officers, agents, employees, and volunteers are named as additionally Insured on this policy pursuant to written Contract, agreement, or memorandum of understanding. City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 ACORD 25 (2016103) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Jean Aguirre 988.2016 ACORD CI The ACORD name and logo are registered marks of ACORD � 1tiek7danagtmuntDlWaimt IIV � REVIEWED i& pAPP'RIOVEO BY 8 �lll� Risk Management Analyst