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OC MENTAL HEALTH (4) - 2015
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OC MENTAL HEALTH (4) - 2015
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Last modified
9/22/2015 3:49:18 PM
Creation date
9/21/2015 4:14:12 PM
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Template:
Contracts
Company Name
OC MENTAL HEALTH
Contract #
A-2015-060-06
Agency
COMMUNITY DEVELOPMENT
Council Approval Date
4/21/2015
Expiration Date
6/30/2016
Insurance Exp Date
7/1/2016
Destruction Year
2021
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A� & CERTIFICATE OF LIABILITY INSURANCE <br />DATE <br />THIS CERTIFICATE IB 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 pollcy(les) 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 III of such endorsement(s). <br />PRODUCER <br />Comprehensive Insurance Services <br />26429 Rancho Parkway South <br />Suite 120 <br />Lake 6_o_reet CA 926_30_ <br />CONT <br />N 8: ACT <br />ac °NO eat: (949)709 -8800 a� 10,(949)709.1666 <br />E•PpmLSg. info @theoompreheneiveinsuranae. co_m <br />I NSURERIS) AFFORDING COVERAGE <br />NAIO0 <br />INSURER A;NOn rofite insurance Alliance of CA <br />11845 <br />INSURED <br />Mental Health Association of Orange County <br />822 Town 6 Country Rd. <br />Orange CA 92868 <br />INSUFURkSStSI Compensation insurance Fund <br />35076 <br />INSURERc;ALOh Snecialty Insurance CO <br />21199 <br />INSURER O; <br />INSURERa: <br />EACH OCCURRENCE <br />I SURER P; <br />A <br />COVERAGES CERTIFICATE NUMBER:GL /Auto /PL /WC 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 />NOR <br />TYPE OF INSURANCE <br />Santa Ana, CA 92701 <br />U <br />PC I Y PF <br />P UCPYEXPY <br />LIMITS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />A <br />CLAIMS -MADE IxJ OCCUR <br />PREMISES ES Be arcu en e <br />$ 500,000 <br />MED EXP(Any one Person) <br />$ 20,000 <br />X <br />2015 - 08472 -M <br />7/1/2016 <br />7/1/2016 <br />PERSONAL B ADV INJURY <br />$ 1,000,000 <br />AGGREGATE LIMIT APPLIES PER <br />GENERAL AGGREGATE <br />S 2,000,000 <br />GENL <br />POLICY j3PE4 [X] LOO <br />PRODUCTS COMP /OP AGG <br />$ 21000,000 <br />$ Detluctlble <br />$ <br />OTHER: <br />AUTOMOBILE LIABILITY <br />(fgAB ntani NGLE LIMIT <br />$ 1,000,000 <br />BODILY INJURY(Per parson) <br />A <br />HX ANY AUTO <br />AUTOS�ED AU7d9ULED <br />NON•OWMED <br />HIRED AUT06 AU708 <br />2015 - 08472 -NPtl <br />7/1/2015 <br />7/1/2016 <br />BODILY INJURY(Per accidan) <br />$ <br />PROPERTY AM <br />Pa accident <br />$ <br />$0 Detluctlble <br />$ <br />X <br />UMBRELLA LIAR <br />_ <br />OCCUR <br />EACH OCCURRENCE <br />$ 2,000,000 <br />AGGREGATE <br />$ - 2,_000,000 <br />A <br />EXCESS LIAR <br />CLAIMS -NAPE <br />2015- 08472 - 0610 -NIP0 <br />7/1/2015 <br />7/112016 <br />_ <br />DED <br />1 X I RETENTION$ 10 000 <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYER$' LIABILITY <br />ANY PROPRIETOR/PARTNERIEXEOUTWE jjY''I��N <br />(MndakMUn NWR EXCWOE01 Iu�J <br />(Mandatory ) <br />N/A <br />9064567 -15 <br />7/1/2015 <br />7/1/2016 <br />X EA M <br />6TATLIT• R <br />E. L. EACH ACCIDENT <br />$ 1,000 000 <br />E.L. DISEASE •EA EMPLOYE <br />$ 11000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />If yes describe under <br />DE 8dRIPTON OF OPERATIONS below <br />C <br />Professional Liability & <br />nP0045731 -04 <br />7/1/2015 <br />7/1/2016 <br />$3,0DD,000AOg11,000,000Ee am $0 Deduotible <br />Abuse or Molestation <br />DESCRIPTION Of OPERATIONS I LOCATIONS/ VEHICLES (ACORD 101, Additional Mementos schedule, maybe attached it more space Is mqulmd) <br />The City of Santa Ana its officers, employees, agents and representatives are included as Additional <br />Insured per Attaahed special City Agreement <br />1 #X41 <br />OFRTIMCATF NOLOFR CANCELLATION <br />Q 1988.2014 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2014/01) The ADORED name and logo are registered marks of ACORD <br />IMSMR "niAm, <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 />20 Civic Center Plaza <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />Richard Rynorl /JGRDMY <br />Q 1988.2014 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2014/01) The ADORED name and logo are registered marks of ACORD <br />IMSMR "niAm, <br />
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