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COMMUNITY HEALTH INITIATIVE OF ORANGE COUNTY (4)
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COMMUNITY HEALTH INITIATIVE OF ORANGE COUNTY (4)
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Last modified
10/23/2024 3:35:59 PM
Creation date
7/1/2024 3:01:36 PM
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Contracts
Company Name
COMMUNITY HEALTH INITIATIVE OF ORANGE COUNTY
Contract #
A-2024-089-04
Agency
Community Development
Council Approval Date
5/7/2024
Expiration Date
6/30/2026
Insurance Exp Date
11/4/2024
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<br />DATE (MM/DD/YYYY) <br />CERTIFICATE OF LIABILITY INSURANCE <br />10/01/2024 <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 />CONTACT <br />PRODUCER Certificate Issuance Team <br />NAME: <br />FAX <br />PHONE <br />Comprehensive Insurance Services(949) 709-8800 <br />(A/C, No): <br />(A/C, No, Ext): <br />E-MAIL <br />26429 Rancho Parkway Southjeremy@thecomprehensiveinsurance.com <br />ADDRESS: <br />Suite 120 <br />Ejhjubmmz!tjhofe!cz!Bohjf!Bdfwfep! <br />INSURER(S) AFFORDING COVERAGENAIC # <br />Lake ForestCA92630Nonprofits Insurance Alliance of California10023 <br />INSURER A : <br />Bohjf!Bdfwfep <br />Ebuf;!3135/21/28!22;66;56!.18(11( <br />INSURED <br />INSURER B : <br />Community Health Initiative of Orange County <br />INSURER C : <br />1505 E. 17th Street, Suite 108 <br />INSURER D : <br />INSURER E : <br />Santa AnaCA92705 <br />INSURER F : <br />CL2410407160 <br />COVERAGESCERTIFICATE 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 />ADDLSUBR <br />INSRPOLICY EFFPOLICY EXP <br />TYPE OF INSURANCELIMITS <br />POLICY NUMBER <br />LTR(MM/DD/YYYY)(MM/DD/YYYY) <br />INSDWVD <br />COMMERCIAL GENERAL LIABILITY 1,000,000 <br />EACH OCCURRENCE$ <br />DAMAGE TO RENTED <br />500,000 <br />CLAIMS-MADEOCCUR$ <br />PREMISES (Ea occurrence) <br />20,000 <br />MED EXP (Any one person)$ <br />AYY2024-4492710/15/202410/15/20251,000,000 <br />PERSONAL & ADV INJURY$ <br />2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ <br />PRO- <br />2,000,000 <br />POLICYLOCPRODUCTS - COMP/OP AGG$ <br />JECT <br />$0 Deductible <br />$ <br />OTHER: <br />COMBINED SINGLE LIMIT <br />AUTOMOBILE LIABILITY 1,000,000 <br />$ <br />(Ea accident) <br />ANY AUTOBODILY INJURY (Per person)$ <br />OWNEDSCHEDULED <br />A2024-4492710/15/202410/15/2025 <br />BODILY INJURY (Per accident)$ <br />AUTOS ONLYAUTOS <br />HIREDNON-OWNEDPROPERTY DAMAGE <br />$ <br />(Per accident) <br />AUTOS ONLYAUTOS ONLY <br />$0 Deductible <br />$ <br />UMBRELLA LIAB <br />OCCUREACH OCCURRENCE$ <br />EXCESS LIAB <br />CLAIMS-MADEAGGREGATE$ <br />DEDRETENTION$$ <br />PEROTH- <br />WORKERS COMPENSATION <br />STATUTEER <br />AND EMPLOYERS' LIABILITY <br />Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. EACH ACCIDENT$ <br />N / A <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYEE$ <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ <br />$1,000,000/1,000,000Aggregate/Occ <br />Social Service Professional Liability <br />A2024-4492710/15/202410/15/2025$2,000,000/1,000,000Aggregate/Occ <br />Improper Sexual Conduct Liability <br />$0 Deductible <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />City of Santa Ana, officers, agents, employees, and volunteers are included as additionally insured on this policy pursuant to written contract or written <br />agreement per attached endorsement NIAC E61. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be <br />excess and noncontributory per attached endorsement NIAC E61. 30 day notice of cancellation with 10 day notice of cancellation for non-payment of <br />premium per policy provision. Waiver of Subrogation applies per attached endorsement NIAC E26. <br />CERTIFICATE HOLDERCANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />City of Santa Ana <br />Risk Management Division <br />AUTHORIZED REPRESENTATIVE <br />20 Civic Center Plaza <br />Santa AnaCA92702 <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD <br /> <br />
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