COMMUNITY SENIORSERV INC. - 2014

Home Browse Search

ACG7S2C CERTIFICATE OF LIABILITY INSURANCE DATE 671061120,4 2014 IVYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the polit ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements). PRODUCER Marsh Risk & Insurance Services 17901 Von Karmen Avenue,Sulte 1100 CONTACT NAME: PHONE plc No EMAIL ADDRESS: (949) 3995800 License 40437153 Wine, CA 92614 INSURERS AFFORDING COVERAGE NAIC# INSURER A: Philadelphia Indemnity Insurance Company 18058 093650- CSS- GAWX -14 -15 INSURED Community SeniorSery INSURER e: Zenith Insurance Company 13269 INSURER C 1200 N. Knollwood Circle Anaheim, CA 92801 INSURER D: MED EXP (Any one person) INSURER E: PERSONAL &ACV INJURY $ 1,000,000 INSURER F: COVERAGES CERTIFICATE NUMBER: LOS- 001512616 -07 REVISION NUMBER:1 THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADOL SUER POLICY NUMBER POLICY EFF MMIDDIYYYY ) POLICY EXP (MMIDO/YYYYI LIMITS A GENERAL LIABILITY PHPK1197912 0710112014 0710112015 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES (Ea occunence $ 100,600 MED EXP (Any one person) $ 5,000 PERSONAL &ACV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $ 3,000,000 X POLICY PRO LOG JECT 1:1 Sexual Misconduct $ 1,000,000 A AUTOMOBILE LIABILITY PHPKII97912 0710112014 0710112015 , COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ ANY AUTO DIED: Comp $500- Collision $1,000 I ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY -DAMAGE Per accident $ It UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEO I I RETENTIONS $ B WORKERS COMPENSATION 2070773205 07101/2014 0710112015 X WC STATU- OTH- ANO EMPLOYERS' LIABILITY YIN OFIFICERI EMBBRI EXCLUDED?ECUTIVE El (Mandatory In NH) NIA E. L. EACH ACCIDENT 1,000,000 $ E. L. DISEASE - EA EMPLOYEE $ 1,000,000 if yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 Tr DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) The City of Santa Ana, its Officers, Officials, Employees, Agents & Volunteers are named additional insured with respoect to the operations of the named insured per the attached CG 2026 endorsement. Such insurance is primary and non- contributory per the ^14vtV W'�C� (�'�✓�'vfr� 4 V �(3 CERTIFICATE HOLDER CANCELLATION City of Santa Ana M -25 PO Box 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Santa Ana, CA 92702 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services John Graef © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD