Laserfiche WebLink
Tori Digitally signed <br />by ran Pierson <br />ac R� CERTIFICATE OF LIABILITY INSURANCEPierson 1153333Date ?0]'005 DATE (MM DD YYYY) <br />��- 06/24/2022 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br />THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE <br />POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), <br />AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, <br />subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not <br />confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />USI INSURANCE SERVICES LLC/PHS <br />41715154 <br />PHONE (877) 532-3486 <br />(AIC, No, Ext): <br />FAX <br />(AIC, No): <br />The Hartford Business Service Center <br />3600 Wiseman Blvd <br />E-MAIL <br />San Antonio, TX 78251 <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE NAICN <br />INSURED <br />INSURER A: Sentinel Insurance Company Ltd. <br />11000 <br />360 BC Group Inc <br />INSURER B: <br />1835 W ORANGEWOOD AVE STE 255 <br />INSURER C <br />ORANGE CA 92868-2066 <br />INSURER D <br />INSURER E : <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 <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INS <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSR <br />SUB R <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />D(MMIDDIYYYYI <br />POLICY EXP <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$2,000,000 <br />CLAIMS -MADE OCCUR <br />XI <br />DAMAGETORENTED <br />PREMISES E <br />$1,000,000 <br />MED EXP(My one person) <br />$10,000 <br />X <br />General Liability <br />A <br />X <br />X <br />41 SBA AD7771 <br />09/01/2021 <br />09/01/2022 <br />PERSONAL B ADV INJURY <br />$2.000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$4,000,006 <br />POLICY ❑ "0- FA]LOC <br />JE <br />PRODUCTS-COMP/OPAGG <br />$4,000,000 <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$2,000,000 <br />BODILY INJURY (Per person) <br />ANY AUTO <br />A <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />X <br />X <br />41 SBA AD7771 <br />09/01/2021 <br />09/01/2022 <br />BODILY INJURY (Per accident) <br />X <br />HIRED NON-O MED <br />AUTOS X AUTOS <br />PROPERTY DAMAGE <br />(Per accident) <br />UMBRELLALIAB <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIM <br />H <br />CLAIMS- <br />MADE <br />AGGREGATE <br />DEO <br />RETENTION$ <br />WORKERS COMPENSATION <br />JEER <br />OTH- <br />AND EMPLOYERS' LIABILITY <br />ISTATUTE <br />ER <br />E.L. EACH ACCIDENT <br />ANY YIN <br />PROPRIETORIPARTNERIEXECUTIVE <br />OFFICERNIEMBER EXCLUDED? <br />NIA <br />E.L DISEASE -EA EMPLOYEE <br />(Mandatory In NH) <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) <br />Those usual to the Insured's Operations. <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />City Of Santa Ana BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br />20 CIVIC CENTER PLZ FL 4 IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />SANTA ANA CA 92701-4058 AUTHORIZED REPRESENTATIVE <br />cl lae-. � C�tIzll� <br />01988-2015 ACORD CORFcKt�r Mogeaml uddon <br />RlVIEVh➢6 ArrRovm Br. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 8j'' %u arcA,aK <br />Kok Managemmr Clmral Aide <br />