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CERTIFICATE OAF LIABILITY INSURANCE
<br />DATE (MMIDDIYYYY)..
<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 have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement($).
<br />PRODUCERVenture Pacific Insurance Services, Inc..... niAME:: CT Venture Pacific lnsura.nce Services.., Inc.
<br />111 Co orate Drive Suite 200 PHONE FAX
<br />Ladera flan�hy CA 92.69'4 (No,No, Extl. 949-297-4900 iAfc,No)! 949-297-4911
<br />E-MAIL
<br />www.venturepacificinsurance.com Lic# OD 10299
<br />INSURED
<br />Comprehensive Housing Services Inc.
<br />8840 Warner Avenue, Suite 203
<br />Fountain galley CA 92708
<br />INSURER(5) AFFORDING COVERAGE NAIL #
<br />Jigs Casualty Insurance Company of America , 19046
<br />--1 American Insurance Comoanv 28932
<br />COVERAGES rFRTIFIICATF NIIMRFR- 47FRR' Qa REVISION NUMBER -
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOWHAVE 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 NTH RESPECT TO WHICH
<br />THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1S SUBJECT TO ALL THE
<br />TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR_.... p,ODI. SUER- ...... .... _.... "POLICY EFF POLICY EXP
<br />LTR TYPE OF INSURANCE POLICY NUMBER MMIDDfYYYY MMIDDfYYYY
<br />-......... LIMITS ......
<br />_
<br />A ,/ COMMERCIAL GENERAL LIABILITY / .....680-3F1'....26214-15-42 '.... 12%27/2016 12/27/2017
<br />EACH OCCURRENCE $
<br />2,000,000
<br />'... CLAIMS -MADE ✓ OCCUR '....
<br />... _..
<br />'DAMIAGE TO RENTED .....
<br />PREMISES (Ea occurrence) $ _.
<br />..
<br />300,000
<br />.
<br />'.... '.., '',
<br />MED EXP (Any one person) $
<br />5,000
<br />PERSONAL &ADV INJURY $
<br />2,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER '...
<br />GENERAL AGGREGATE..... $
<br />4,000,000
<br />POLICY PRO-
<br />JECT LOC
<br />PRODUCTS - COMPIOP AGG $
<br />OTHER:
<br />$
<br />A AUTOMOBILE LIABILITY 680-3F125214-15-42 12127/20113 12/27/2017
<br />COMBINED
<br />BINEDacc�denISINGLELIMIT $
<br />1„000,000
<br />ANY AUTO '...
<br />BODILY INJURY (Per person)
<br />OWNED SCHEDULED
<br />BODILY INJURY (Per acc6denl) $
<br />..... ....
<br />....:.AUTOS ONLY AUTOS
<br />......
<br />HIRED NON -OWNED
<br />PROPERTY DAMAGE $
<br />AUTOS ONLY ✓... AUTOS ONLY
<br />.(Per accident)
<br />UMBRELLA LIAB OCCUR '
<br />EACH OCCURRENCE S
<br />- -
<br />-
<br />EXCESS LIAB CLAIMS MADE ,
<br />AGGREGATE $
<br />�I.. DED RETENTION g. (� „,.,°
<br />$
<br />WORKERS COMPENSATION °'��'lj ..
<br />AND EMPLOYER'S' LIABILITY YIN 4J
<br />��
<br />.. STATUTE EORH-
<br />_.
<br />ECUTIVE
<br />E L EACH ACCIDENT $
<br />EXCLUDED N f AI"w..
<br />OF i�
<br />(Ma'ANYPRndatory ir7MNH) 1
<br />E L DISEASE- EA EMPLOYEE $
<br />Ifos, describe under
<br />.��
<br />DESCRIPTION OF OPERATIONS below ”'
<br />E.L. DISEASE - POLICY LIMIT $
<br />B Professional E&O Liability MG84689' 1115/2016 1115/2017
<br />$1,000,000 Per Claim / Aggregate
<br />DESCRIPTION OF OPERATIONS) LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />The City of Santa Ana, its officers, agents, and employees are additional Insured in regards to General Liability, endorsement
<br />attached.
<br />Coverage is primary & non -Contributory.
<br />•30, day notice of cancellation "10 day notice for non-payment of premium.
<br />1129214.ulReven
<br />The City of Santa Ana,
<br />it's officers, employees, agents, and
<br />representative
<br />20 Civic Center Plaza M-16
<br />Santa Ana CA 92702
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE, EXPIRATION DATE THEREOF, NOTICE WILL BE (DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE /
<br />James Barton '1`'
<br />O 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />3.5688389 1 COMPR-L 1 16-17 GL., AutO, E&G I Maureen Philen 1 1,/9/201.7 3::19:24 PM /PDT) I Paque 1. of 4..
<br />
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