Laserfiche WebLink
DATE(MM/DD/YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE <br /> 031 8/2026 <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 CONTACT <br /> NAME: <br /> Lockton Companies,LLC for G&A PHONE FAX <br /> 3657 Brairpark Drive a/C Lo Ext: A/C No <br /> MA <br /> Suite 700 ADDRESS: certificates@gnapartners.com <br /> Houston,TX 77042 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURERA: Zurich-American Insurance Company 16535 <br /> INSURED INSURER B: <br /> G&A Outsourcing,LLC dba:G&A Partners Labor Contractor,for co-employees of: <br /> Straight Talk Clinic Inc INSURER C 7 <br /> 17220 Katy Freeway Suite 350 INSURER D: <br /> Houston,TX 77094 <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:26TX0381247530 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 LIMITS <br /> LTR INSD WVD POLICY NUMBER MM/DD MM/DD <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> DAMAGE TO <br /> CLAIMS-MADE OCCUR PREMISES <br /> Ea occurrDence $ <br /> MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ <br /> POLICYEl PRO LOC JECT PRODUCTS-COMP/OPAGG $ <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 /> UMBRELLA LAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION X PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 <br /> A OFFICER/MEMBEREXCLUDED? ❑ NIA X WC 33-76-171-01 03/01/2026 03/01/2027 <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 /> Location Coverage Period: 03/01/2026 03/01/2027 Client# 6910-CA <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> so-employees <br /> Straight Talk Clinic Inc Project/Job:TBD <br /> only those c <br /> Coverage i provided for 3785 S Plaza Dr <br /> of,but not subcontractors Santa Ana ,CA 92704 <br /> to: <br /> Endorsements:Waiver of Subrogation <br /> J�AP_ <br /> PROVED <br /> CERTIFICATE HOLDER CANCELLATION u Tran Nguyen at 4:34 pm,Mar 18,2026 <br /> City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> its City Council, Officers,officials,employeres, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> and Volunteers 20 Civic Center Plaza(M-25) ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Santa Ana,CA 92701 <br /> AUTHORIZED REPRESENTATIVE <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and loao are reaistered marks of ACORD <br />