Laserfiche WebLink
Digially signed by Ted Pierson <br />Tod Pierson Deds: 2023A6.1409:5110-07'OP <br />ACORO® CERTIFICATE OF LIABILITY INSURANCE <br />`� <br />DAM(MMIDDNYYY) <br />1 5/26/2022 <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 />LoVME: <br />1050 & T as hin A Marsh and McLennan Agency, LLC <br />1050 W Washington Street, Suite 233 <br />Tempe AZ 85281 <br />CONTACT <br />Marie Shaffer <br />PHONE . 602-792-2343 FAX No <br />E-MAIL <br />DOREss: mshaffer lovitt-touche,com <br />INSURERS AFFORDING COVERAGE <br />NAM # <br />INSURER A: HCC Specialty Insurance Company <br />11243 <br />INSURED NATIHOU-Cl <br />Nati's House <br />INSURER B: <br />INSURER C: <br />Neutral Ground <br />INSURER D: <br />1733 Valencia St <br />Santa Ana CA 92706 <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 859157384 REVISION NIIMRFR- <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 />TYPEOFINSURANCE <br />ADDL <br />J= <br />SUBR <br />vinic <br />POLICYNUMBER <br />POLICY EFF <br />MMIDONYYY) <br />POLICY EXP <br />IMMIODNYYYI <br />LIMITS <br />A <br />X <br />COMMERCIALGENERAL LIABILITY <br />CLAIMS -MADE � OCCUR <br />H21SS2007101 <br />1/6/2022 <br />1/6/2023 <br />EACH OCCURRENCE <br />$1,000,000 <br />0 ETO RENTED <br />P E I S Ea acaunenm <br />$50,000 <br />X <br />MED EXP (my onePerson) <br />$ 5,000 <br />11000 <br />PERSONAL&AOVINJURY <br />$1,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY JET 7X I LOC <br />GENERALAGGREGATE <br />$3,000,000 <br />PRODUCTS-COMP/OP AGO <br />$1,000,000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />H21SS2007101 <br />1/6/2022 <br />1/6/2023 <br />COMBINED tSINGLE LIMITMe <br />$1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />IXANY <br />BODILY INJURY ) <br />(Per aomtlent <br />$ <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />e accident) <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DIEDRETENTION$ <br />It <br />WORKERS COMPENSATION <br />PER OTH- <br />ANDEMPLOYERS'LIABILITY YIN <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ <br />ANYPROPRIETORIPARTNER/EXECUTIVE <br />OFFICEWMEMBEREXCLUDEDT ❑ <br />N/A <br />E.L. DISEASE - EA EMPLOYE <br />$ <br />(Mandatory In NH) <br />If <br />Dyas, describe untler <br />DESCEll OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMB <br />$ <br />A <br />Professional Liability <br />H21SS2007101 <br />1/6/2022 <br />1/6/2023 <br />Each Claim <br />1000000 <br />SexuaVPhysiml Abuse <br />Prof Aggregate <br />SAMLAggregate <br />3:000:000 <br />1,00G,000 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORO 101, Additional Remarks Schedule, may be aaaehed it more seam is sequined) <br />Certificate holder is named Additional Insured to General Liability coverage if required by written contract, subject to all policy terms, conditions, definitions and <br />exclusions. Primary/Non-Contributory applies. Notice of Cancellation for Specified Entity, City of Santa Ana. <br />"City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this policy pursuant to written contract, agreement, or <br />memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and <br />noncontributory." <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />The City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Division 10 <br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Rbil Mangenatl miske, <br />Santa Ana CA 92701 REvtwaDa APlmw®Or <br />191WRI-ZU15 AGGRO Gil <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />