|
PUBLLAW01 VRXKUMAR2
<br />J'9 /1lJ-
<br />CERTIFICATE OF �ArBf.�TY INSURANCE
<br />DATE '
<br />4r1$r2014 YY)
<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(ias) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may roquire an endorsement, Astatement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsements).
<br />PRODUCER License # 0725293
<br />Arthur J. Gallagher & Co. Insurance Brokers of CA., Inc.
<br />505 dBrand A lvd, Suite 000
<br />CONTACT
<br />NAME:
<br />PHONE $18 539 -2300 - PAX 81
<br />LALg.t[,,_Ee Jn�) _......� AtC NOi: { $) 539 ^2301
<br />E MA(L
<br />ADDRESSii
<br />INS URER(S)AFFORDINGCDVERAGE _ NAIGN
<br />wsURERA:Nonprofits' Insurance Alliance of CA_
<br />INSURED T
<br />INBVRER B: ��
<br />INSURERS:
<br />Public Law Center
<br />11,19URER D :
<br />601 Civic Center Drive
<br />Santa Ana, CA 92701
<br />_
<br />INSURERE:
<br />ELL
<br />0210112015
<br />INSURER Fo
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOW_ N MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILT
<br />TYPE OF INSURANCE
<br />R POUCYNUMBER
<br />PA "CY ERF
<br />POLICY XP
<br />_
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,00
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />X
<br />201422050NP0
<br />02/01/2014
<br />0210112015
<br />PREMISET( a
<br />$ 500,000
<br />MED ENE (Any ono as on)
<br />$ 20,000
<br />PERSONAL &ADV INJURY
<br />$ 1,000,00
<br />X ABUSE
<br />X $1ty1M1$1MM
<br />GENERAL AGGREGA_ E
<br />$ 2,000,00
<br />CEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMIPOP AGG
<br />.- ...._....-
<br />$ 2,000,00
<br />_. POLICY Pft0- LOC
<br />$
<br />AUTOMOBILE LIABILITY
<br />W
<br />COMBINED SINGLE LIMIT
<br />,fEe accident)
<br />1,000r 00
<br />$ ,,rv„
<br />A
<br />ANV AUTO
<br />201422050NP0
<br />02/01/2014
<br />02/01 /2015
<br />BODILY INJURY (Per person)
<br />$
<br />ALL OW NCO SCHEDULED
<br />X HIIRED AUTOS X NON -OWNED
<br />„„ AUTOS
<br />BGDILY INJURY tParsccidenti
<br />$
<br />PROPERTY DAMAGE
<br />f''ER ACCIDENT _,�
<br />u
<br />$
<br />UMBRELLALIAR OCCUR
<br />EXCESS LIAB CLAIMS -MADE
<br />®y+G1'�W+^'�!~
<br />o-E, TV
<br />,,,,.+
<br />ar""""`
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE -
<br />rr
<br />DED RETENTION
<br />$
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YIN
<br />ANY PROPRIETOWPAKPIERIEXECUTNE
<br />OFFICERtMEMBER EXCLUDED?
<br />(Mandatory inNIB
<br />NIA
<br />^
<br />E +'
<br />(„�
<br />{a{(i.
<br />'(
<br />FiCr4`
<br />OYOB
<br />tx iN
<br />WC STATU- OTH-
<br />U 91
<br />EL- -
<br />S EACH ACCIDENT
<br />E.L. DISEASE - EA EMPLOYS
<br />$ — —
<br />$
<br />I'yyS describe uder
<br />OfSDRIPTIDN OF n OPERATIONS below
<br />p,SSVS
<br />1
<br />E,L. DISEASE - POLICY LIMIT
<br />$
<br />DESCRIPTION OFOPERATIONS I LOCATIONS IVERCLES (Attach ACORD 104, Addilonat Remarks Schadule, If meta space is Ymphrad)
<br />The City of Santa Ana, Its officers, employees, agents, volunteers and representatives are named additional insured with respect to the operations of tho
<br />named Insured per the attached CG 2026 endorsement, Such Insurance is primary and noncontrlbutory..
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES RE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City Of Santa Ana
<br />Ci y of Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Santa Ana, CA 92701 ---
<br />AUTHORIZED REPRESENTATIVE
<br />r,I fl �I
<br />zb, nuiv
<br />O 19BO.2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and loco are maistorod marks of ACORD
<br />
|