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THRIVE SANTA ANA, INC. (4)
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THRIVE SANTA ANA, INC. (4)
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Last modified
12/29/2022 9:23:43 AM
Creation date
12/29/2022 9:22:45 AM
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Contracts
Company Name
THRIVE SANTA ANA, INC.
Contract #
A-2020-044-01
Agency
Community Development
Council Approval Date
3/3/2020
Insurance Exp Date
1/1/1900
Destruction Year
0
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,acoRh? CERTIFICATE OF LIABILITY INSURANCE <br />1111 <br />DATE(MMIDOA'YYY) <br />1 11/01/2022 <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 />Baker, Romero & Associates Insurance Brokers, Inc. <br />750 Terrado Plaza #238 <br />Covina, CA 91723 <br />CONTACT <br />NAME: Christine R Sousa <br />ACNN E (626)332.2258 q/C Na; (626)339.9921 <br />nooaEss: christine@bakerromero.com <br />INSURERS AFFORDING COVERAGE <br />NAIC If <br />License #: OG22790 <br />INSURER A: Scottsdale Insurance Company <br />41297 <br />INSURED <br />INSURERB: State Compensation Insurance Fund <br />Thrive Santa Ana, Inc. <br />INSURERC: <br />P.O. Box 1935 <br />Santa Ana, CA 92703 <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 00008709368052 REVISION NUMBER: 3 <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 <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDrIYYY <br />POLICY EXP <br />MMIDDM'YY <br />LIMITS <br />A <br />COMMERCIAL GENERAL ABILITY <br />CLAIMS -MADE OCCUR <br />CPS7680941 <br />10131/2022 <br />10/3112023 <br />EACH OCCURRENCE <br />$ 1000000 <br />PREMISES Eaoccurma <br />$ 100,000 <br />MED EXP (Anyone person) <br />$ 5 000 <br />PERSONAL&ADVINJURY <br />$ 1000000 <br />GENLAGGREGATE <br />X <br />LIMITAPPLIES PER: <br />POLICY ❑ JEo LOC <br />GENERALAGGREGATE <br />$ 2000000 <br />PRODUCTS - COMPIOP AGO <br />$ 2.000.000 <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea acmden <br />$ <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />$ <br />UMBRELLA LIAB <br />OR <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESSLIAB <br />DED RETENTION$ <br />$ <br />B <br />WORKERS COMPEN ATIOIN <br />AND EMPLOYERS' IN <br />ANY PROPRIETORIPARTNEWEXECUTIVE Y <br />OFFICEWMEMBER EXCLUDED? <br />(Mandatary In NH) <br />NIA <br />9294438-2022 <br />03117/2022 <br />03/1712023 <br />X STATUTE ER'_ <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYE <br />$ 1,000,000 <br />It yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$ 1,000,000 <br />C <br />D <br />DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) <br />Location: Walnut/Daisy Micro -Farm: 1901, 1903, 1907, 1909 W. Walnut St., Santa Ana, CA 92703 <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />CRS <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Printed by CRS on 11/01/2022 at 12:52PM <br />
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