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4288 Wiseplace, a Ca Corp Certificate of Insurance (page 1 of 1) 10/28/201505:38:26 PM
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<br />•`° RD' CERTIFICATE OF LIABILITY INSURANCE D TE(MM2O
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<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(Ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain pollclos may require an endorsement. A statement on this certificato does not confer rights to the
<br />certificate holder in lieu of such andoreement(s).
<br />PRODUCER
<br />CQNTAQT
<br />NAME:
<br />SeleolSo[utions Insurance Services, LLC #0127711
<br />1350 Carlback Avenue
<br />Walnut Creels, CA 945913
<br />PI-IONo Exl :86$'500 6359 �n c No ; 855 801-1449
<br />•MAIL
<br />ADDRES
<br />PRODUCER
<br />CUSTOMER 11) M
<br />INf1URER S AFFORDING COVERAGE mm _
<br />NAIQ ft
<br />GENERAL LIABILITY
<br />INSURED
<br />_
<br />INSURERA: Philadel hia lndemnit insuranGO COrYI an 18058
<br />INSURER e : New York Marine & General Insurance 16508
<br />Wiseplace, a Ca Corp
<br />1411 N. Broadway
<br />Santa Ana, CA 82706
<br />INSURER C:
<br />INSURER p ^
<br />INSURER E : ^µ
<br />INSURER F:
<br />%1VVr_KAUC7S CERTIFICATE NUMBER- Pr-VI41nnl All IRAMMO
<br />THIS 18 T4 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE PEEN ISSUED TO THE )NSURED NAMED A13OVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH
<br />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 />7Ypp OF INSURANCE
<br />ADDL
<br />SUER
<br />POLICY NUMBER
<br />POLICY EFF
<br />AIMIPDIYYYY)
<br />POLICY EXP
<br />IMMIODNMI
<br />LIMITS
<br />20 Civlo Center Plaza
<br />GENERAL LIABILITY
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<br />EACH OCCURRENCE $ 1,006,060
<br />COMMERCIALGENE.RALLIA6ILITY
<br />CLAIMS -MADE 91 OCCUR
<br />DAMAGE TO P E ISIS RM? encs $ 1�.DDD
<br />MED EXP (Any one person) $ 5,00D
<br />A
<br />_
<br />PHPKI278339
<br />111/2016
<br />1/112016
<br />PERSONAL &, ADV INJURY S 1,000,000
<br />_
<br />GENERAL AGGREGATE $ 2,000,000-
<br />GEN'LAGGREGATELIMIT APPLIES PER:
<br />PRODUCTS -COMPIOPAGO $ 2,o0p,00q
<br />J POLIQYF. I El PRD, LOC
<br />g
<br />AUTOMOBILE
<br />+%
<br />LIABILITY
<br />ANY AUTO
<br />COMBINED SINGLE LIMM
<br />(>=a accident) S 1.000,000
<br />BODILY INJURY (Per person) $
<br />d
<br />ALLOwNFpAUTOS
<br />BODILY INJURY (Per acUdent) $
<br />A I
<br />V
<br />SCHEDULEDAUTOS
<br />HIREDAUTOS
<br />PHPK1276335
<br />11112015
<br />1!112016
<br />PROPERTY DAMAGE
<br />(Peraccidanl) $
<br />V
<br />NON-OWNEDAUTOS
<br />g
<br />$
<br />UMBRELLA LIAB .f OCCUR
<br />ERCHOCCURRENCE $ 1,000,000
<br />A
<br />EXCESS LIAR CLAIMS -MADE
<br />P H UB 48 6326
<br />11112015
<br />1! 1!2016
<br />AGGREGATE $ 1,000,00)
<br />DEDUCTIBLE
<br />Y' J
<br />RETENTION S 10,000
<br />$
<br />B
<br />WORKBRS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIrTORIPARTNERIPXECUTIVE
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatory In NH)
<br />If yyesC, describe unOFderOPERATIONS [.Z.E.L.
<br />pESRIPTION
<br />NIA
<br />W0201500006833
<br />8/161/2015
<br />6!1&!2016
<br />VMC STATLI- OTB^
<br />.0 ER
<br />E.L,EACHACODENT g 1,000,000
<br />E.L. DISEASE -EA EMPLOYEE $ 1,00,000
<br />DISEASE - POLICY LIMIT $ 1,000,000
<br />A
<br />P;orasslonal Liability (Errors and Omiaelons) ,
<br />PHPK1278535
<br />111=15
<br />11112016
<br />$1,))0,00015210001000
<br />PESCRIFTlON OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Ramarha Sahednlo, If more space is required)
<br />The Professional Llabilliy Limits shown represant the Per Claim/Aggregate Limits of Liability,
<br />GER I iviCA t E HOLDER C;ANC:r=1 I ATI()N
<br />Community Development Agency
<br />SHOULD ANY OF THE ABOVE DESCRISED POLICIES BE CANCELLED BEFORE
<br />Administrative Services Divislon M-25
<br />THE EXPIRATION DATE THEREOF, NOTICE
<br />WILL. 13E DELIVERED IN
<br />Attn: Terri Eggers, Senior Community Development Analyst
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTRQRI2ED REPRFSFNTATIVE
<br />20 Civlo Center Plaza
<br />Santa Ana, CA 92701
<br />er
<br />01988-2009 ACORD CORPORATION. All rights reserved.
<br />ACORD 26 (2009109) The ACORD name and logo are registered marks of ACORD
<br />
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