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SIMPLETHERAPHY, INC
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Last modified
6/15/2026 9:21:14 AM
Creation date
6/10/2025 3:02:17 PM
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Contracts
Company Name
SIMPLETHERAPHY, INC
Contract #
N-2025-148
Agency
Human Resources
Expiration Date
6/30/2028
Insurance Exp Date
4/11/2027
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AC-®a DATE(MMIDDNYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 6i10/2026 <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 NAME: <br /> Lockton Affinity,LLC PHONE FAXIA/C - <br /> 10895 LOWELL AVE STE 300 Ertl: AIC No; <br /> -MAIL <br /> ADDRESS: <br /> OVERLAND PARK,KS 66210-1679 <br /> INSURER(S)AFFORDING COVERAGE NAIL rk <br /> 913-652-5715 INSURER A:Houston Casual Compm 42374 <br /> INSURED Simple'Therapy,Inc. INSURER B:Scottsdale Insurance COmnanv 41297 <br /> Halycon Behavioral,LLC INSURER c:COntinental CaSualtv COTnUanV 20443 <br /> 1080 Shaw Ave St 105 INsuRER D:Ironshore Specialty Insurance Co 25445 <br /> Fresno CA 93711 INSURER E: <br /> INSURER F; <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER; XXXXXxX <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 /> ILSR TYPE OF INSURANCE A L POLICY EFF POLICY EXP LIMITS <br /> POLICY NUMBER MM/D MMID . <br /> COMMERCIAL GENERAL.LIABILITY NOT APPLICARLL EACH OCCURRENCE $ XKXXXXX <br /> CLAIMS-MADE1:1 OCCUR <br /> PREMISES Ea occurrence $ = <br /> MEG EXP(Anyone person). $ X UCYCAM <br /> PERSONAL&ADV INJURY $ )C>CXX= <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ X)CKX= <br /> POLICY❑PRO- <br /> JECT X��LOC PRODUCTS-COMPIOP AGG $ X —YXX <br /> OTHER: . $ <br /> AUTOMOBILE LIABILITY NOTAPPLICABLE - CO BINEDLSINGLE MTjEa $ )CX)CK= <br /> ANY AUTO BODILY INJURY(Per person) $ � <br /> OWNED SCHEDULER BODILY INJURY(Per accident) $ <br /> AUTOSONLY AUTOS )C)C)CXXXX <br /> HIRED NON•OWNED PROPERTY DAMAGE $ � <br /> AUTOS ONLY AUTOS ONLY Per eocidant <br /> $ X CKXXXX <br /> UMBRELLA LIAR OCCUR NOTAPPLICA$LE EACH OCCURRENCE $ )COCX XX <br /> EXCESS LIAR HCLAIMSAIADE AGGREGATE $ X•XDcxXXX <br /> BED I I RETENTION$ r $ XXXXXXX _.. <br /> WORKERS COMPENSATION NOT APPLICABLE IP H- <br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER <br /> ANY PROPMETORIPARTNERIEXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ )DDCX) X <br /> (MandaOFtCERlMEn NH)EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ ... <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> A Tech EO-Gyb N N H26TG3367603 5/11/2026 5/11/2027 $5M,Ret$25k <br /> )3 XS Tech EO-Cyb EKS3623513 S/l lnf)26 5/11/2027 $5M xs$SM <br /> C DO/EPI.IM 8019002204 4/11/2026 4/11/2027 $1M/$IM/$IM <br /> D I MngCrEO HC7CAB4HM9006 5n012026 5/30/2027 1 $2M Per Claim/$2MAgg <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Addldonal Remarks Schedule,may be attached It more apace Is required) <br /> THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER,APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S)REFERENCED. <br /> City of Santa Ana,its City Council,officer,official,enployee,agent,and volunteer is included as an additional insured as respects to Managed Care E&O, <br /> APPROVED <br /> By Tu Tran Nguyen at 7:30 am,Jun 15,2026 <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 PROVISIONS. <br /> Attention:Human Resources Department <br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE, <br /> Santa Ana,CA 92702 � ~ <br /> 1988.20 ACORD CORPOARATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />
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