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4286 Wisepiace, a Ca Corp
<br />Certificate of Insurance
<br />(page 1 of 1) 02/03/2016 02:51:33 PM
<br />AC RV CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMID srvY)
<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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the Certificate holder is an ADDITIONAL INSURED, the policy(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 lieu of such endorsemont(s).
<br />PRODUCER
<br />CONTACT
<br />NA
<br />SelectSoluCons Insurance Services, LLC
<br />40127711
<br />1350 Carlback Avenue
<br />PRONE 866.500.6359 q1C Ne; (855) $04.8449
<br />EMAIL
<br />ADDRESS;
<br />_,,,-IN5URER(Si AFFQROING COVERAGE NAICM
<br />Walnut Creel(, CA 94596
<br />_
<br />INSURER A: New York Marine& General Insurance i 0
<br />INSURED
<br />INSURER e: Philadelphia indemnify ur nCe Company1 $
<br />INSURER C;
<br />Wiseplace, a Ca Corp
<br />1411 N. Broadway
<br />Santa Ana, CA 92706
<br />INSURER D:
<br />INSURER E ;
<br />INSURER F:
<br />-
<br />COVERAGES CERTIFICATE NUMBER: RFVlglCINI MIIMRPP�
<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 />ILTR
<br />TYPE OF INSURANCE
<br />L
<br />WILL Be DELIVERED IN
<br />P UCY NUMBER
<br />POLICY EFF
<br />DD
<br />POLICY EXP
<br />MIDDIYYYY
<br />LIMITS
<br />I/ COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ❑✓ OCCUR
<br />AUTHORIZED REPRESENTATIVE"R..
<br />20 Civic Center Plaza, M-25
<br />Santa Ana, CA 92701xafia�u
<br />EACH OCCURRENCE $ 1,000,000
<br />PA A TffIT
<br />• trance $ t00.000
<br />MED EXP (Any one person) $8.000
<br />PERSONALBAOV INJURY $
<br />e
<br />Yee
<br />PHPK1438852
<br />11112016
<br />IIWO1T1.000,000
<br />GEN'LAGGREGATE LIMIT APPLIES PER:
<br />✓ POLICY ❑ JEOT L__1 LOC
<br />GENERAL AGGREGATE $2.000.000
<br />PRODUCTS-COMPIOPAGG S 2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED ELIMIT
<br />Ea accident $ 1,000,000
<br />✓
<br />ANY AUTO
<br />BODILY INJURY(Per bused) $
<br />✓
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />PHPK1438852
<br />! IMP2016
<br />1/1/2017
<br />BODILY INJURY Per accident $
<br />C I
<br />B
<br />,!
<br />✓ NON -OWNED
<br />HIRED AUTOS AUTOS
<br />!
<br />PROPERTYDA AGE
<br />Para ri,taJO,_..._......... $
<br />$
<br />✓
<br />UMBRELLA LIAO
<br />✓
<br />OCCUR
<br />EACH OCCURRENCE $1,000,000
<br />B
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />PHUS526799
<br />V112016
<br />1/112017
<br />AGGREGATE $ 1,000,000
<br />DED I ✓
<br />I RETENnON$
<br />$
<br />A
<br />COMPENSATION
<br />AweKERSND EMPLOYERS'
<br />ANDEMPLOYERS'LIADILITY Y/N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFPICERIMEMBER EXCLUDED?
<br />(Mandatory In NH)
<br />If yea,e under
<br />NIA
<br />WC201500006833
<br />3/1!V2015
<br />0/15/2016
<br />OTH-
<br />✓ STATUTE Eft
<br />,,,
<br />16,000
<br />E.L. EACH ACCIDENT $,00
<br />E.L. DISEASE. -EA EMPLOYE' $ 1,000,000
<br />E, L. DISEASE -POLICY LIMIT $ 7,000p00
<br />DESC DESCRIPTION
<br />DESCRIPTION OF OPERATIONS balnw
<br />a
<br />Professional UataNy(Errors and Omissions)
<br />PHPK1438862
<br />1/112016
<br />_ _
<br />41/2017
<br />$1,600,000/$2,000,000
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES tACORD 101, Additional Remarks Schedule, may be attached if more space Is om.lmd)
<br />Community Development Analyst City of Santa Ana, Community Development Agency are named as Additional Insured as their Interests may appear in regards
<br />to General Liability policy per attached endorsement. The Professional Liability Limits shown represent the Per Claim/Aggregate Limits o Liability.
<br />�0(�Ok
<br />CERTIFICATE HOLDER CANCELLATION --___--
<br />Q 1988.2614 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Community Development Analyst
<br />THE EXPIRATION DATE THEREOF, NOTICE
<br />WILL Be DELIVERED IN
<br />City of Santa Ana, Community Development Agency
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />Attn: Sylvia Vazquez
<br />AUTHORIZED REPRESENTATIVE"R..
<br />20 Civic Center Plaza, M-25
<br />Santa Ana, CA 92701xafia�u
<br />L✓1:•�
<br />Q 1988.2614 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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