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4286 Wiseplace, a Ca Carp Certificate of Insurance
<br />(page 1 of 1) 02/04/2016 12:37:01 PM
<br />A� R"� CERTIFICATE OF LIABILITY INSURANCE
<br />DAT2141201sYYY}
<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 COVERA13E 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 poliey(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and condltfons of the pollcy, certain policles may require an endorsement. A statement on thls certffleate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CO AOT
<br />NAME:
<br />SelectSolutlons Insurance Services, LLC
<br />#0127711
<br />1350 Carlback Avenue
<br />PHON u 868-500 8359 FAX Ne ; 865 804-8448
<br />M L
<br />ADDRESS:
<br />INSURER(s) AFFORDING COVERAGE NAIC N
<br />Walnut Creek, CA 94596
<br />INSURER A: New York Marine & General Insurance 16608 -
<br />TNSUREO
<br />INSURERS; Philadelphia nit Insurance Qompariy8058
<br />INSURERC;
<br />Wlseplace, a Ca Corp
<br />1411 N, Broadway
<br />Santa Ana, CA 92706
<br />INSURERD;
<br />INSURER E ;
<br />INSURERF:
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER.-
<br />THIS
<br />UMBER:
<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 WAVE BEEN REDUCED BY PAID CLAIMS,
<br />LTR
<br />TYPE OF INSURANCE
<br />Santa Ana, CA 82701
<br />POLICYNJMBER
<br />PO ICY EFF
<br />MMIDOIYYYY
<br />POLICY EXP
<br />MMIDDfYYYY
<br />LIMITS
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADS 1-1OCCURSSDM&
<br />EACH OCCURRENCE $ 1,000,000
<br />AMARENTED
<br />oc $ 100,000
<br />MED EXP (Any one person) 5,000
<br />PERSONAL &ADV INJURY $ 1,000,000
<br />B
<br />Yes
<br />PHPK1438662
<br />11112018
<br />1/1/2017
<br />GENLAGGREGATE UMITAPPUn PER:
<br />_ POLICY ❑ j10T F7 LOC
<br />GENERALAGGREGATE $ 2,000,000
<br />PROOUCTa- COMPfOP AGG $ 2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea aside $ 1,000,000
<br />BODILYINJURY (Psrperson) $
<br />ANY AUTO
<br />ALLOWNEDscHEDULED
<br />AUTas AUTOS
<br />PHPK1438852
<br />11112018
<br />11112017
<br />BODILY INJURY (Per accident) $
<br />B
<br />HIREDAUTOS, NONALTONED
<br />Yes
<br />PReCPI aiYDAMAGE - $
<br />$
<br />UMBRELLA t -IAB
<br />OCCUR
<br />EACH OCCURRENCE $ 1,000,000
<br />B
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />Yes
<br />PHUB528799
<br />11112016
<br />1/112017
<br />AGGREGATE $ 1,000,000
<br />DED RETENTION$
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE8116120'IB
<br />OFFICERfMEMBER EXCLUOEO9 Y
<br />(Mandatory In NH)
<br />NIA
<br />M201SOM06833
<br />811612018
<br />PER a7H-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />EL DISEASE - EA EMPLOYEE $ 1,000,000
<br />Ifyes, desndha undar
<br />DESCRIPTION OF OPERATIONS below
<br />E,L, DISEASE- POLICY LIMIT $ 1,000000
<br />B
<br />Professional UablLty (Errors and Omtsslons)
<br />PHPK1430052
<br />1112016
<br />111/2017
<br />$1,000,0001 $2100C,000
<br />DESCRIPTION OFOPERATiON6I LOCATIONS! VEHICLES (AGORA 101, Additional Remarks Schedule, may be attached If mom space Is required)
<br />The City of Santa Ana, Its officers, employees, agents, volunteers and representatives are named as Additional Insured with respect to General Liability policy
<br />per attached endarsement,This insurance Is Primary and Non-contributory to any other insurance provided as respects General Liability policy per attached
<br />endorsement, The Professional Liability Limits shown represent the Per Claim/Aggregate Llmlts of LlabiRy.
<br />CERTIFICATE HOLDER CANCELLATION
<br />O 1988-2014 ACORD CORPORATION. All rlghts 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 />The 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 82701
<br />AWHORIZEDR-"EE�P-�RESENTATIVE
<br />IZ,�,
<br />O 1988-2014 ACORD CORPORATION. All rlghts reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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