|
A� or CERTIFICATE OF LIABILITY INSURANCE
<br />)
<br />ovo3i2ozo
<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 be endorsed. If SUBROGATION 15 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 endorsement(s).
<br />PRODUCER
<br />CONTACT
<br />NAME: Dylon Riley
<br />Newfront Insurance Services, LLC
<br />PHONED Ell, (415) 754-3635 FAX xo
<br />55 2nd Street
<br />ADDRESS: dylon.riley@newfrontinsurance.com
<br />Floor 18
<br />San Francisco CA 94105
<br />INSURER(S)AFFORDING COVERAGE
<br />NAIC R
<br />Citizens Ins Co
<br />e1SURERA: of America
<br />31534
<br />INSURED
<br />INSURER B: Hartford Casualty Ins Co
<br />29424
<br />HF&H Consultants, LLC
<br />INSURERC: Gemini Insurance Company
<br />10833
<br />INSURER D :
<br />201 N Civic Or #230
<br />Walnut Creek CA 94596
<br />INSURER E :
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: REVISION MUM SEE:
<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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />p
<br />POLICYNUMBER
<br />POLICY EFF
<br />MM/DDIVYYY
<br />POLICY EXP
<br />MM/DDIYYVY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X OCCUR
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />DANT
<br />MAGE TO REED
<br />PREMISES Ea occurrence
<br />$ 1,000,000
<br />MED EXP(My one erson)
<br />$ 10,000
<br />PERSONAL&ADV INJURY
<br />$ 2,000,000
<br />A
<br />X
<br />OBF-D681476-02
<br />09/06/2019
<br />09/06/2020
<br />GEN'L
<br />X
<br />AGGREGATE LIMIT APPLIES PER:
<br />PRO-
<br />POLICY1:1 JECTPRO- LOC
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />PRODUCTS -COMP/OP AGG
<br />$ 4,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILELIABILITY
<br />COMBINED SINGLE LIMB
<br />Ea accident
<br />$ INCLUDED
<br />BODILY INJURY (Par person)
<br />$
<br />ANY AUTO
<br />A
<br />A AUTOS LL OWNED ALTOSULED
<br />HIREDAUTOS X NON -OWNED
<br />AUTOS
<br />X
<br />OBF-D681476-02
<br />09/06/2019
<br />09/06/2020
<br />BODILY INJURY (Par accident)
<br />$
<br />X
<br />ROPERTY DAMAGE
<br />Zero-
<br />Per accitlent
<br />$
<br />$
<br />X
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 3,000,000
<br />AGGREGATE
<br />$ 3,000,000
<br />A
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />OBF-D681476-02
<br />09/06/2019
<br />09/06/2020
<br />LIED I X I RETENTION$$10,000
<br />B
<br />WORKERSCOMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />OFFICER/MEMB R ANYPROPRlUORPARTNE /EXE=lVE ❑NIA
<br />(Mandatory In NH)
<br />If yes, describe under
<br />57 WEC ZR5765
<br />09/06/2019
<br />09/06/2020
<br />XPTERTOTH-
<br />AER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYE
<br />$ 1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />c
<br />Professional Liability
<br />Deductible $10,000
<br />VCPL065988
<br />09/O6/2019
<br />09/O6/2020
<br />Each Claim - $2,000,000
<br />Aggregate - $2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are listed as additional insured on the General Liability with respect to
<br />services provided by the Named Insured. Coverage is Primary & Non -Contributory. 30 Days' Notice of Cancellation With 10 Days' Notice for Non -Payment of
<br />Premium in accordance with the policy provisions. Pi.EVl I ED & APPROVED
<br />"fir.
<br />By Risk IMAN4iqEMENT DivisiON
<br />D
<br />City of Santa Ana
<br />Risk Management Division, 4th Floor
<br />20 Civic Center Plaza
<br />Santa Ana
<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 />CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />/7
<br />@ 1988-2014 ACORD CORPORATION. All rights
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
|