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ORANGE COUNTY MENTAL HEALTH ASSOCIATES 1
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ORANGE COUNTY MENTAL HEALTH ASSOCIATES 1
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Entry Properties
Last modified
8/23/2021 2:48:44 PM
Creation date
11/24/2004 2:10:17 PM
Metadata
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Template:
Contracts
Company Name
Mental Health Association
Contract #
A-2004-043
Agency
Community Development
Council Approval Date
3/15/2004
Expiration Date
6/30/2005
Insurance Exp Date
7/12/2006
Destruction Year
2010
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4 <br />I/ <br />A -a- 0—R� CERTIFICA11_ OF LIABILITY INSURAW E os127Z20o5' <br />PRODUCER (949) 709-8800 FAX (949) 709-1668 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Comprehensive Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE, <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />22342 Avenida Empresa ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Suite 200 <br />RSM, CA 92688 INSURERS AFFORDING COVERAGE NAIC # <br />INSURED INSURFRA: NONPROFITS' INSURANCE ALLIANCE F CA <br />Mental Health Association of Orange County INSURERB <br />822 Town & Country Rd. INSURER C: <br />Orange, CA 92668 /j INSURER D: _ <br />A— J$ u(V INSURER E. <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />DD' <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />GENERAL LIABILITY <br />2005-08472-NPO <br />07/12/2005 <br />07/12/2006 <br />EACHOCCURRENCE <br />$ 1,000,00 <br />DAMAGE TO RENTED <br />PREMIS <br />$ 100,00 <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE [ X ] OCCUR <br />MED EXP (Any one Person) <br />$ 10,000 <br />A <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 2,000,00 <br />GEHL AGGREGATE LIMIT APPLIES PER. <br />PRODUCTS - COMPIOP AGO <br />$ 2,000,00 <br />— <br />POLICY Fj jEa X LOD <br />AUTOMOBILE <br />LIABILITY <br />2005-08472-NPO <br />07/12/2005 <br />07/12/2006 <br />COMBINED SINGLE LIMIT <br />X <br />ANY AUTO <br />l <br />(EAeccitlen) <br />$ <br />1,000,000 <br />$ <br />ALL OWNED AUTOS <br />BODILY INJURY <br />SCHEDULED AUTOS <br />(Per Pervm) <br />A <br />BODILY INJURY <br />$ <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />(Peracordenl) <br />PROPERTY DAMAGE <br />$ <br />-- <br />(Peraccitleni) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHER THAN EA ACC <br />$ <br />ANY AUTO <br />$ <br />AUTO ONLY AGG <br />EXCESSNMBRELLA LIABILITY <br />2005-08472-UMB-NPO <br />07/12/2005 <br />07/12/2006 <br />EACH OCCURRENCE <br />$ 2,000,00 <br />11 OCCUR CLAIMS MADE <br />AGGREGATE <br />_ <br />$ 2,000,000 <br />$ <br />A <br />$ <br />DEDUCTIBLE <br />_ <br />$ <br />X RETENTION $ 10, DO <br />WCSTATU- OTH- <br />WORKERS COMPENSATION AND <br />I <br />E L. EACH ACCIDENT <br />$ <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNEWEXECUTIVE <br />F.L. DISEASE - EA EMPLOYEE <br />$ <br />OFFICER/MEMBER EXCLUDED? <br />H yes, de cnbe under <br />SPECIAL PROVISIONS nel. <br />E.L. DISEASE POLICY LIMIT <br />$ <br />OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />ERTIFICATE HOLDER IS NAMED AS ADDITIONAL PER ATTACHED ENDORSEMENT #CG2026 <br />*EXCEPT 10 DAYS FOR NON-PAYMENT <br />APPROVED AS TO F'ClRM <br />y <br />v,r ATo unr noG 1C0 YPAM!` I I ATU1M <br />City 'li <br />J`� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />CITY OF SANTA ANA, ITS OFFICERS, AGENTS AND <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILLX$'6WXT]4 MAIL <br />EMPLOYEES <br />CDBG <br />*30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT <br />ATTN DOR I S TURLEY <br />d(J6)€XIYIt�XAX)Cki(d4XrX9EitKl(iGYXK�1£M�t#XT�H�XaEXYdH6XA�XltXXX <br />20 CIVIC CENTER PLAZA M-25 <br />W(U(rNcX Yi)(d41(M*U"YXlk"*x6"kx"kbmAAYwXXXXXXXX <br />AUTHORIZED REPRESENTATNE <br />SANTA ANA, CA 92701 <br />Richard Eynon, CIC/JEREMY <br />ACORD 25 (2001108) <br />©ACORD CORPORATION 1988 <br />
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