|
ACCORD® DATE(MMIDD/YYYY)
<br /> ACCORD CERTIFICATE OF LIABILITY INSURANCE 1/29/2024
<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 CONTACT
<br /> NAME: Maureen(MoMo)McDonald
<br /> Arthur J. Gallagher Risk Management Services, LLC PHONE FAX
<br /> 500 N Brand Boulevard, Suite 100 (Arc.No.Exe:818.539.8625 [Arc,No):818.539.8725
<br /> Glendale CA 91203 ADDRESS: maureen_mcdonald@ajg.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> License#:0D69293 INSURER A:Service American Indemnity Company 39152
<br /> INSURED INTEHOU-03 INSURER B:Berkley Regional Insurance Company 29580
<br /> Interval House
<br /> P.O. Box 3356 INSURER C:
<br /> Seal Beach, CA 90740 INSURER D:
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:1254379073 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP
<br /> LTRINSnrQ POLICY NUMBER (MM/DD/YYYYL(MM/DD/YYYYL LIMITS
<br /> B X COMMERCIAL GENERAL LIABILITY Y HHS 8525626-17 10/1/2023 10/1/2024 EACH OCCURRENCE $1,000,000
<br /> DAMAGE TO RENTED
<br /> CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $500,000
<br /> MED EXP(Any one person) $20,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000
<br /> PRO
<br /> X POLICY JECT LOC PRODUCTS-COMP/OP AGG $3,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
<br /> (Ea accident)
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY _ AUTOS ONLY (Per accident)
<br /> B UMBRELLA LIAB X OCCUR HHS 8525626-17 10/1/2023 10/1/2024 EACH OCCURRENCE $2,000,000
<br /> X EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000
<br /> DED X RETENTION$f1 $
<br /> A WORKERS COMPENSATION Y SATISO405003 2/1/2024 2/1/2025 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE NrA E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED'?
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> B Commercial Property HHS 8525626-17 10/1/2023 10/1/2024 BLKT Building Limit $6,465,315
<br /> BLKT BPP Limit $931,540
<br /> Deductible $1,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Policy:Crime Coverage
<br /> Policy Term: 10/1/2022 To 10/1/2025
<br /> Policy#: 107707393
<br /> Carrier:Travelers Casualty and Surety Company of America
<br /> Employee theft:Limit:$2,000,000/Deductible:$15,000
<br /> ERISA:Limit:$2,000,000
<br /> Forgery&Alteration:Limit$2,000,000/Deductible:$15,000
<br /> Theft Money and Securities:Limit:$2,000,000/Deductible:$15,000
<br /> See Attached...
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PRC\
<br /> Attn: Risk Management Division , Risk MRnagementDivision
<br /> 20 Civic Center Plaza, 4th Floor AUTHORIZED REP ESENTATIVE 4, REVIEWED(Si.APPROVED BY:
<br /> Santa Ana, CA 92701 • A"�`e Acu ul°
<br /> ®• Risk Management Specialist
<br /> I
<br /> ©1988-2015 ACORD /
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
|