Laserfiche WebLink
acoRO CERTIFICATE OF LIABILITY INSURANCE <br />" <br />DATE (MMIDDI'/YYY) <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />11/2/2016 <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 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 Ileu of such endorsoment(s). <br />PRODUCER <br />NAME, Certificate Issuance Team <br />Comprehensive Insurance Services <br />PHONE (949)709-8800 FAx <br />AIC No Ex q(C No'1949)709-1669 <br />26429 Rancho parkway South <br />aoDRlesS:info@thecomprehensiveinsurance.com <br />Suite 120 <br />INSURER(S) AFFORDING COVERAGE NAICA <br />Lake Forest CA 92630 <br />INSURER A:Non rofits Ins Alliance of CA 11845 <br />INSURED <br />INSUR2RS.00MJDWGSt Insurance Company 112177 <br />Delhi Center <br />INSURER C: <br />505 E. Central Ave. <br />EACH OCCURRENCE$ 1,000,000 <br />INSURER D: <br />NSURERE: <br />Santa Ana CA 92707 <br />INSURERFt <br />COVERAGES CERTIFICATE NUMBER:GL/Auto/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 />ILTR <br />TYPE OF INSURANCE <br />s <br />POLICY NUMBER <br />MMIOOIYYPF <br />M,0UCYYxP <br />LIMITS <br />X I COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE$ 1,000,000 <br />A <br />cLAINISAIADE X❑ OCCUR <br />NIAG <br />DA , n NT <br />ES Eeocnce $ 500, 000 <br />Pcum <br />X <br />2016 -01376 -NPO <br />11/1/2016 <br />11/1/2017 <br />NIED EXP (Ay onepersan) $ 20,000 <br />PERSONAL I ADV IN,.URY 1,000,000 <br />GEN'L AGGREGAT= LIMIT APPLIES PER'. <br />GENERAL AGGREGATE ; 3,000,000 <br />POLICY PRO- � <br />LOC <br />PRODUCTS -COMP/GP AGG $ 3,000,000 <br />$0 Deductible $ <br />OTHER_ <br />AUTOMOBILE <br />LIABILITY <br />CONIB.11CDSV3LE L MIT $ 1,000,000 <br />Ea awiden[ <br />BODILY INJURY(Per person) $ <br />A <br />AN(AUTO <br />AL! OPINED SCHEDULED <br />AUTOS AUTOS <br />2015 -01375 -NPC <br />11/1/2016 <br />11/1/2017 <br />BODILY INJURY (Par arcidenry $ <br />Y` <br />HIRED AUTOS X NON-01,ED <br />AUTOS <br />PROPERTY DAMAGE <br />Peraccldent 8 <br />$O Deductible !$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE $ <br />EXCESSLIAB <br />CLAIM S-IADE <br />AGGRE ATE <br />DED I I RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />X PER OTH- <br />ANO EMPLOYERS' LIABILITY YIN <br />STATUTE ER <br />L. EACH ACCIDENT $ 1,000,000 <br />ANY PROPRIETOR/PARTNERIEXECUTIVEE. <br />OFFICERIMEMBER EXCLUDED? ❑ <br />NIA <br />E.L. DISEASE - EA EPAPLOYE' $ 1,000,000 <br />8 <br />(Mandatory In NH) <br />W V5900420 <br />11/1/2016 <br />11/1/2017 <br />II Yes, descnbe under <br />EL DISEASE - POL!C'Y OMIT I $ 1 000 000 <br />GE SOP PT:ON OF OPERATIONS below <br />A <br />Social Sery Professional <br />2015 -01376 -NFO <br />11/1/2016 <br />11/1/2017 <br />$3,000.000Agq/1,000,0000cc 10 Deductible <br />A <br />Improper Sexual Conduct <br />2016 -01376 -NPO <br />11/1/2016 <br />11/1/2017 <br />$1,000000Agq/i 000,0000cc $0 Deductible <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) <br />The City of Santa Ana its officers, employees, agents and volunteers are included as Additional Insured <br />automatically per written contract or agreement- per attached endorsement CG2026. 30 day notice of <br />cancellation with 10 day notice of cancellation for non-payment of premium per policy provision. This <br />insurance is Primary and Non-contributory per attached endorsement NIAC E61. <br />City of Santa Ana <br />20 Civic Center Plaza <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 />Ern in/JEREMY <br />O 1988-2014 ACORD CORPORATION. All riahts <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD e.V)CtJ�� �CUS' 1�_ )e�C <br />INS025I?01na1) r"� 1- <br />