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HUIMAOPT -04 R0QCA1
<br />A►CC7R[�►'" DATE (MMfDOIYYYY)
<br />- CERTIFICATE OF LIABILITY INSURANCE 9123/2015
<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(ios) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder In lieu of such endorsement(s).
<br />PRODUCER License # 0564249 CONTACT
<br />NAME:
<br />Heffernan Insurance Brokers PHONE PAx
<br />6 Hutton Centre Drive, Suite 504 IAIC. No Ext 1 (714) 361 -7700 ArC,No 1 714 ) 361 -7701
<br />Santa Ana CA 92707 E -MAIL
<br />AnnarPS.c•
<br />INSURED
<br />Human Options
<br />5540 -A Trabuco Road
<br />Irvine, CA 92620
<br />INSURERS) AFFORDING COVERAGE
<br />NAIL #
<br />INSURERA: Nonprofits Insurance Alliance of California
<br />01184
<br />INSURER B: Berkshire Hathaway Holrnestate Insurance Company
<br />20044
<br />INSURER C ^...
<br />..�.
<br />INSURER D:
<br />PbU - EFF
<br />J.MMID DIYYYY.
<br />INSURER E
<br />.._...... ..... _.....
<br />'... LIMITS
<br />INSURER F:
<br />X
<br />rnVPRAI Ffi r ;=RTIFIrATF NI IMRFR^ iaccrccinkr KH rnnec0.
<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.
<br />LTR
<br />TYPE OF INSURANCE
<br />ADOL
<br />INSD
<br />' BIR
<br />^NVD
<br />., w,.....
<br />POLICY NUMBER
<br />PbU - EFF
<br />J.MMID DIYYYY.
<br />POLICY EXP
<br />MMIDDIYYYY
<br />.._...... ..... _.....
<br />'... LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL ILIA BILITY
<br />CLAIMS -MADE , OCCUR
<br />X
<br />201 501 1 43NPO
<br />0912312015
<br />09/2312016
<br />EACH OCCURRENCE
<br />AMACE`TCFRENTE _.......
<br />PEE. M SES_{Ea occurrence)
<br />$ 11000,000
<br />_....
<br />500,000
<br />..,,... _.... m... _.,.,......._.,........�
<br />MED EXP (Any one person)
<br />$ 20,000
<br />..m__m .._........._ .......,.........._......
<br />PERSONAL &, ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER
<br />POLICY �.,......_! PRO•... LOC
<br />1 JECT
<br />GENERAL AGGREGATE
<br />PRODUCTS - COM.PiOP AGG
<br />$ 3,000,000
<br />$ 3,000,000
<br />ISEXUAL MISCONDU
<br />$ 1,000,000
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBIINdIEaD SINGLE LIMIT
<br />$ 1 ,000,000
<br />A
<br />ANY AUTO
<br />201501143NPO
<br />0912312015
<br />09/2312016
<br />BODILY INJURY (Per person)
<br />$
<br />ALL OWNED AUTOS
<br />AUTOS AUTOS
<br />BODILY INJURY Per aceidant
<br />( )
<br />S
<br />NON -OWNED
<br />HIRED AUTOS X AUTOS
<br />PROPERTY DAMAGE...
<br />Per accident
<br />$
<br />$
<br />X
<br />UMBRELLA LIAE.
<br />.:
<br />OCCUR
<br />', EACH OCCURRENCE
<br />_
<br />$ 5,000,000
<br />A
<br />EXCESS LIAE
<br />CLAIMS MADE
<br />201501143UMBNPO
<br />0912312015
<br />0912312016
<br />AGGREGATE
<br />-0,
<br />$ 5,000,000
<br />I7EC I X RETENTIC?N $ 10,000
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PRCPRIETORIPARTNERIEXECIJTIVE
<br />OFFICERIMEMSER EXCLiUDED7
<br />(Mandatory In NH) ..
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />N f A
<br />HUWC601528
<br />0410112015
<br />04/0112016
<br />'. X STATUTE DTRII
<br />E.L. EACH ACCIDENT
<br />...._... -_ _._...
<br />''..... E.L. DISEASE. - EA EMPLOYEE
<br />$ "1,000,000
<br />..
<br />$ 1,000,000
<br />........_-
<br />E.L. DISEASE - POLICY LIMIT
<br />- -...
<br />$ 1,000,000
<br />A
<br />A
<br />Professional Liabili
<br />Sexual Misconduct
<br />201501143NPO
<br />201601143NPO
<br />09/2312015
<br />0912312015
<br />09/2312016
<br />0912312016
<br />Occurrance 1,000,000
<br />(Occurrence 1,000,000
<br />DESCRIPTION OF OPERATIONS d LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Re: As per Contract or Agreement on file with Insured. The City of Santa Ana, its officers, employees, agents and volunteers and representatives are named
<br />as additional insureds. With respect to claims arising out of the operations and uses performed by or on behalf of the named) insured, such insurance as is
<br />afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds.
<br />CERTIFICATE H OI IDFR ("AINr_FI I ATIr)M
<br />V 1955 -2014 AL;URD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Community Development Agency
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza, M -25
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana.., CA 92701
<br />V 1955 -2014 AL;URD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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