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CLEAR-1
<br />OP ID: CG
<br />,4coRo, CERTIFICATE OF LIABILITY INSURANCE
<br />`.�•- '
<br />FDATE5/0(MM/DD/YYYY)
<br />03/2024
<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 831-337.4661
<br />Clarion Pacific Insurance Digitally
<br />35 N.. PacificsAve.
<br />t�u e rc Acevedo Acevedo
<br />CONTACT Coan Gardiner
<br />NAME:
<br />FAX 831-612-1810
<br />( o, x : (A/C, No):
<br />ADDRESS:COryn@paER(S)A.COm
<br />Date: 20
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />a ny
<br />30104
<br />_
<br />INSURED
<br />Clearsource Financial Consulting
<br />7960 Soquel Dr. Ste: 8363
<br />Aptos, CA 95003
<br />INSURER B : Travelers Property Casualty Co
<br />25658
<br />INSURER C:
<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 TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />DDL
<br />INSD
<br />UBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDD/YYYY
<br />POLICY EXP
<br />MMIDD/YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE X OCCUR
<br />X
<br />X
<br />57SBABB8VBF
<br />12/09/2023
<br />12/09/2024
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />1,000,000
<br />$
<br />MED EXP (Any oneperson)
<br />$ 10,000
<br />PERSONAL & ADV INJURY
<br />$ 2,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />X
<br />POLICY El JJECT1:1 LOC
<br />PRODUCTS - COMP/OPAGG
<br />$ 4,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />2,000,600
<br />$
<br />BODILY INJURY Perperson)
<br />$
<br />ANY AUTO
<br />57SBABB8VBF
<br />12/09/2023
<br />12/09/2024
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY Per accident
<br />$
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />DED RETENTION $
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />Y/N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />UB-8M759710-24-42-G
<br />01/01/2024
<br />01/01/2025
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />$
<br />OFFICER/MEMBER EXCLUDED? ❑
<br />(Mandatory in NH)
<br />N /A
<br />E.L. DISEASE- EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />$
<br />A
<br />Professional Liab
<br />57SBABB8VBF
<br />12/09/2023
<br />12/09/2024
<br />Occurence
<br />2,000,000
<br />Aggregate
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />RE: Citywide Indirect Cost Allocation Plan and Internal Service Funds Cost
<br />Allocation Methodology. City of Santa Ana, its officers, employees, agents,
<br />and representatives are Additional Insureds with respect to General
<br />Liability per the attached endorsements or as required by written contract.
<br />Insurance is Primary and Non -Contributory. Attached waiver of
<br />City of Santa Ana
<br />Risk Management Division,
<br />4th Floor
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />ACORD 25 (2016/03)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF
<br />ACCORDANCE WITH THE POLICY PRC
<br />oR.N a Risk ManagmumtDMsian
<br />f ° REVIEWED & APPROVED BY:
<br />REPRESENTATIVE
<br />o; ,; Rem
<br />Risk Management Specialist
<br />© 1988-2015 ACORD I
<br />The ACORD name and logo are registered marks of ACORD
<br />
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