COMMUNITY SENIORSERV, INC DBA MEALS ON WHEELS ORANGE COUNTY

Home Browse Search

CERTIFICATE OF LIABI itally signe DATE(11IDOM'Y1') THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND jjONFERS NO CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTf � j BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A dRT{CT�g REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain polio this certificate does not confer riahts to the certificate holder in lieu of such endorsemantfeL PRODUCER Bolton Insurance Services LLC 3475 E. Foothill Boulevard Suite 100 Pasadena CA 91107 INSURED Community SeniorSery Inc dba Meals on Wheels 1200 North Knollwood Circle Anaheim CA 92801 HOLDER. THIS THE POLICIES , AUTHORIZED IITIONAL INSURED provisions or be endorsed. may require an endorsement. A statement on 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 ADDLSUBR INSD I VIVID POLICYNUMBER POLICYEFF MWDOM POLICY EXP MMIDD/YYYY LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ff] OCCUR Y Y PHPK2434485 7/1/2022 7/1/2023 EACH OCCURRENCE $1,000000 DAMAGE TO RE TED PREMISES Eaoccunence $1,000,000 MED EXP (Anyone person) $ 20.000 PERSONAL&ADV INJURY $11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY 0JECT ❑OC CT GENERAL AGGREGATE $3.000.000 PRODUCTS-COMP/OPAGG $3,000,000 $ OTHER: I A AUTOMOBILE LIABILITY PHPK2434485 7/l/2022 7/1/2023 COMBINED SINGLE LIMIT (En accident) $1,000,000 X ANYAUTO BODILY INJURY (Per person) $ I OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Peraocident $ _ A X UMBRELLALIAB OCCU PHUB822109 7/12022 7/l/2023 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 EXCESS LIAR CLAIRMS-MADE DED X RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNEWEXECUTIVE M OFFICERIMEMBEREXCLUOED9 N/A Y COVVC353257 7/1/2022 7/1/2023 X PER ERH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under E.L DISEASE - POLICY LIMIT $1,000.000 DESCRIPTION OF OPERATIONS belmv A A C Professional Liability AbuselMolmalion Cyber Liability TI PHPK2434485 PHPK2434485 ESLGO39484501 7/1/2022 7/l/2022 7/1/2022 7/l/2023 7/12023 7/1/2023 Each Incident Aggregate Umit Aggregate omit $1,000,000 $1,000,000 $3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mare space is required) GL AI & WOS applies per PIGLDHS1011 attached, only if written by contractlagreement. GL PNC applies per PIGL0050712 attached. WC Waiver of Subrogation applies per WC9904IOC attached. Additional Insured(s): City of Santa Ana City of Santa Ana 20 Civic Center Plaza (M-30) PO Box 1988 Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 4'm gel „�y ©1988.2015 ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 1tlek MuuganentDhtdan REVIEWED & APPROVED BY: Risk Management5peci Aht