Laserfiche WebLink
PKUJKIN-01 <br />AANAYA <br />DATE7/11 Y) <br />1812024 Bnoza <br />CERTIFICATE OF LIABILITY INSURANCE <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 terns 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 />PIASC Insurance Services, Inc. <br />5800 S. Eastern Avenue <br />NAMEACT Nora Wolkoff <br />PHONE FAX <br />A/C. No, Ext): (AIC. No): <br />su AIL . nora@piascins.com <br />Suite 400 <br />Los Angeles, CA 90040 <br />INSURER $ AFFORDING COVERAGE <br />NAIC q <br />INSURER A: State Compensation Ins.Fund <br />35076 <br />INSURED <br />INSURER B: <br />INSURER C : <br />Project Kinship <br />INSURER D: <br />2215 N. Broadway Suite #2 <br />Santa Ana, CA 92706 <br />INSURER E : <br />INSURER F <br />COVERAGES CFRTIFIr:ATF NIIMRFR- rFtnclnM MnMGco. <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 />TYPE OF INSURANCE <br />ADOLSUBR <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXPJJR­ <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />EACH OCCURRENCE <br />$ <br />DAMAGE TO RENTED <br />P a occumen <br />GEN'L <br />MED EXP (Anyoneperson) <br />$ <br />PERSONAL&ADV INJURY <br />$ <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY JE0 LOC <br />OTHER: <br />GENERALAGGREGATE <br />IS <br />PRODUCTS - COMPIOPAGG <br />$ <br />IS <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />AUTOS ONLY AUTN6rNED <br />COMBINED SINGLE LIMIT <br />Ea accitlen <br />BODILY INJURY Per son <br />$ <br />BODILY INJURY Per accident <br />$ <br />PeOF.ER-enf AMAGE <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />AGGREGATE <br />DED RETENTION$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORMARTNEWEXECUTIVE ❑ <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatary in NH) <br />f yes,be antler <br />DESCRIPTIRIPTION OF OPERATIONS below <br />NIA <br />9342586.24 <br />7/1112024 <br />7I1112025 <br />)( PER OTH- <br />T E <br />EL EACH ACCIDENT <br />1,p00,Opp <br />E.L DISEASE - EA EMPLOYE <br />1,000,000 <br />EL.DISEASE - POLICY LIMIT <br />11000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES ACORD 101, Additional Remarks Schedule, maybe attached If more space is required) <br />WORKERS COMPENSATION PROOF OF( OVERAGE ONLY— <br />_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana gym.,,, ,.•,•,. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza ;'� "°^•^°' ` �'^ i° = ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92702 .n: - G.. Ir-11 t <br />w•=.. x. , AUTHORRED REPRESENTATIVE <br />L_ -� <br />ACUHU Z5 (ZUTelUJ) ©1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />