COMMUNITY SENIORSERV, INC. - 2010

Home Browse Search

J!??Rb® CERTIFICATE OF LIABILITY INSURANCE OP ID PC DATE[MM1DDIYYYY) COMM_45 08/09/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Chapman ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License #0522024 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. 0, Box 5455 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Pasadena CA 91117-0455 Phone:626-405-8031 Fax:626--405-0585_ INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Ph11ada1phl& Znaucance Company 23850 INSURER B: Zenith Insurance Company Co unit SeniorServ, Inc. INSURER C: 12 N. nollood Circle Anaheim CA 992802 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IrOrl LTR NSR TYPE OF INSURANCE POLICY NUMBER DAPO FFENT T Mi. DD Y l.l1. "T' LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X X COMMERCIAL GENERAL LIABILITY PHPK589427 07/01/10 07/01/11 PREbtISES Eaocauence $100,000 CLAIMS MADE I OCCUR MED EXP (Any one person) s5,000 X Professional Liab PERSONAL & AOV INJURY $1,000,000 GENERAL AGGREGATE s3,000,000 GENL AGGREGATE LIMIT APPLIES PER: - PRODUCTS -COMPOPAGG $1,000,000 POLICY SECT 1 1 LOO AU TOMOBILE LIABILITY COMBINED SINGLE LIMIT $1000000 A X ANY AUTO PHPK589427 07/01/10 07/01/11 Eaatident) denl) (Ea accident) ALL OWNED AUTOS AS T ED ??hh BODILY INJURY P r e n $ SCHEDULED AUTOS p? ' e p rso ) ( X HIRED AUTOS BODILYINJURY $ X NON-OWNED AUTOS `-- R K Per accident) _ $500 comp ded gTO rr?eY ER AlN1GE 0 1tY All t ? e e I, P8 $ $looo Coll ded t . tar AGELUIBILITY I AUTO ONLY - EA ACCIDENT $ M ANY AUTO / / OTHER THAN ^ ^EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACHOCCURRENCE $ 5000000 A X OCCUR CLAIMSMADE PHUB312539 07/01/10 07/01/11 AGGREGATE $ DEDUCTIBLE $ X RETENTION $ 10000 $ WOR AND KERS COMPENSATION EMPLOYERS' LIABILITY X TORY LIMITS ER B ANY PROPRIETOWPARTNEWEXECUTIVE-a OFFICEWMEMBEREXCLUDED? 2070773201 07/01/10 07/01/11 E.L. EACH ACCIDENT $ 1000000 - ??j (Mandatory In NH) -- E.LDISEASE - EAEMPLOYEE $1000000 11 yes, doscribo under SPECIAL PROVISIONS below G.L. DISEASE - POLICY LIMIT S 1000000 OTHER A Property PHPK589427 07/01/10 07/01/11 Blkt Cts 2349968 A Crime PHPK589427 07/01/10 07/01/11 Em 1 Dish 200000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS A0090 BY ENDORSEM ENT / SPECIAL PROVISIONS The City fo Santa Ana, Its Officers, Officials, Employees, Agents & Volunteers are named additional insured with respect to the operations of the named insured per the attached CG 2026 endorsement. Such insurance is primary and non-contributory per the attached endorsement. Workers Compensation coverage excluded, evidence only. 10 days notice of (Contd..) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR City of Santa Ana REPRESENTATIVES. P . O. BOX 198$ ALIT RIZED R PRESENTATIVE Santa Ana CA 92702 AGOHU 25 (2009/01) `-' ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD