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WISEPLACE (8)-2017
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Last modified
3/25/2020 11:02:01 AM
Creation date
9/19/2017 10:09:44 AM
Metadata
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Template:
Contracts
Company Name
WISEPLACE
Contract #
A-2017-099
Agency
COMMUNITY DEVELOPMENT
Council Approval Date
4/18/2017
Expiration Date
6/30/2018
Insurance Exp Date
8/15/2018
Destruction Year
2023
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ih. ' CERTIFICATE OF LIABILITY INSURANCE <br />DA2/(6/203.7n <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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and condition of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certlfleats holder In lieu of such andorsemen a). <br />PRODUCER <br />SAME,CT Lydia Castro <br />SelectSolutions Insurance Services <br />1350 Carlback Avenue <br />FA HosMAJL am,(866)500.6359 FAX (929) 9510077 <br />ADDRESS: lydiac®selectaolutionoins.00m <br />Suite 100 <br />INSURE AFFORDING COVERAGE NAILS <br />INSURER A:Philadel hia Consolidated Holding <br />Walnut Creek CA 94596 <br />INSURED <br />INEURERB:New York Marine & General Insurance 16608 <br />INSUKHRC: <br />Wiseplace, a Ca Corp <br />INSURER D1 <br />1411 N. Broadway <br />INSURERS: <br />Santa Ana CA 92706 <br />1 INBURERF: <br />COVERAGES CERTIFICATENUMBER:17-18 Master 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 ER <br />TYPE OPINBURANCE <br />POLICY NUMBER <br />M UD ryEFr <br />MIMNO E%P <br />LIMITS <br />A <br />$ COMMERCLALOENERALUABILITY <br />CLAIMS-MADEX❑ OCCUR <br />EACH OCCURRENCE $ 1,000,000 <br />PREMISES Ea OCCUrranne)$ 100,000 <br />MED EXP (Any one person) 51000 <br />X <br />PHPK1596372 <br />1/1/2017 <br />1/1/2010 <br />PERSONAL &ADV INJURY $ 11000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />%( POLICY ❑JJECT ❑LOC <br />GENERAL AGGREGATE $ 2,000,000 <br />PRODUCTS-COMPIOPAGG $ 2,000,000 <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY$ <br />007FIED SINGLE MIT 1,000,000 <br />Eo accident) <br />BODILY INJURY (Per person) $ <br />A <br />X <br />ANY AUTO <br />AUTOS NED AUT03ULEU <br />PHPX1596372 <br />1/1/2017 <br />1/1/2018 <br />BODILY INJURY (Per descent) $ <br />HIRED Alfi05 AUTNDOWNEU <br />PROPERTY DAMAGE $ <br />X <br />UMBRELLA LIAR <br />X <br />OCCUR <br />EACH OCCURRENCE $ 1,000,000 <br />AGGREGATE $ 1,000,000 <br />A <br />EXCESS IJAB <br />CLAIMS -MADE <br />DEO <br />X <br />I RETENTION$ 10 000 <br />_ <br />$ <br />IPHUBS69220 <br />1/1/2017 <br />1/1/2010 <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOMPARTNEMEXECUTIVE <br />(Mandatory Inn NH EXCLUDED? ❑ <br />( er ) <br />IF yes, deserts under <br />DESCRIPTION OF OPERATIONS below <br />N/A <br />W02D3600006833 <br />8/15/2016 <br />8/15/2017 <br />X PER OTH- <br />STATUTE <br />E. L. EACH ACCIDENT DENT 1,000,000 <br />E.L. DISCASE EA EMPLOYE $ 1,000,000 <br />E. L. DISEASE, POLICV LIMIT $ 1 000,000 <br />A <br />Proi'esaional Liah (E&O) <br />PHPX1596372 <br />1/L/2017 <br />1/1/2010 <br />$1,000,000 $2,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached brown apace b regalmd) <br />Community Development Analyst City of Santa Ana, Community Development Agency are named as additional <br />insured as their interests may appear in regards to General Liability. The Professional Liability Limits <br />shown represent the per claim/aggregate limits of liability. q <br />Community Development Analyst <br />City of Santa Ana, Community Development <br />Attn: Sylvia Vazquez <br />20 Civic Center plaza, M-25 <br />Santa Ana, CA 92701 <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 />REPRESENTATIVE <br />icia Trevino/NORJA <br />All rkthts <br />ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD <br />INS026 (201401) <br />�4 <br />
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