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Entry Properties
Last modified
2/2/2023 1:11:49 PM
Creation date
6/22/2018 10:18:44 AM
Metadata
Fields
Template:
Contracts
Company Name
HB STAFFING
Contract #
A-2018-147
Agency
PERSONNEL SERVICES
Council Approval Date
6/5/2018
Expiration Date
6/30/2021
Destruction Year
2026
Notes
For Insurance Exp. Date see Notice of Compliance
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CATHENT-01 PPISA <br />CERTIFICATE OF LIABILITY INSURANCE °A AMM;°°' YY <br />n.vh.tnn4R <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 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 endorsements,), <br />PRODUCER 2 J� CT <br />INSURED <br />Insurance Services, LLC / INSURICA <br />Avenue,#240 <br />CathyJon Enterprises, Inc. <br />2120 Main Street, Ste 250 <br />Huntington Beach, CA 92648 <br />COVERAGES CERTIFICATE NUMBER: RFVICInN NHMRi <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 ANO CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR ADDL SUBR POLICY EFF POLICY EXP <br />T TYPE OF INSURANCE POLICYNUMBER LIMITS <br />A X <br />COMMERCIAL GENERAL LLBBILITY <br />EACH OCCURRENCE $ 1,000,000 <br />CLAIMS -MADE � OCCUR <br />PRA590849205 0510112018 <br />05/9112019 <br />_ <br />DAM iGEETO RENTED _ 1001090 <br />X <br />coUrrei <br />MEDEXPIAn ane arson J_ 101000 <br />PERSONAL &ADV INJURY $ 1+000,000 <br />GEYL <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE $ 2,000,000 <br />X <br />POLICY v JECT LOC <br />PRODUCTS -COMP/OP AGG 219001000 <br />THERL._._ <br />ABUSIVE ACTS 1,000,000 <br />A AUTOMOBILE LIABILITY <br />COMBINED LIMIT 11000,000 <br />ANY AU TO <br />PRA590849205 05/01/2019 <br />05/0112019 <br />BODILY INJURY Perperson) $ <br />ULEO <br />AOUTOS'nONLV AUppTOppS <br />-BODILY INJURY Per accident $ <br />X AM1fOS X AUTOSAELY D <br />AMAGE <br />Ce <br />ONLY <br />Pe�acc t $ <br />$ <br />B LLAUAS X OCCUR <br />EACH OCCURRENCE 11000,000 <br />UABGLAIMsMADE <br />L <br />UMB549949905 95t01t2016 <br />95!91!2959 <br />AGGREGATE g 1,000,000 <br />XIRETENTION$ 0 <br />WORKERS COMPENSATION <br />H_ <br />'ER OTH- <br />AND EMPLOYERTUAEIUTY V/N <br />STATUTE EO <br />E. L. EACH ACCI DENT $, <br />eEXCLUDED?ECUTIVE ❑ N/A <br />(Mandatory�n NH) <br />If yes, describe under <br />E . DISEASE EAEMPLOYE <br />—"' <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />A Crime <br />PRA590849205 05/01/2018 <br />05/01/2019 <br />$2,500 ded 50,000 <br />A Professional Liab, <br />PRA590849205 05101/2018 <br />05/01/2019 <br />$111 <br />DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If mom space Is required) <br />The City of Santa Ana, its officers, employees, agents, and representatives are named as additional Insured as respects to general liability, The City of Santa <br />Ana shall be govon 30 days written notice of cancellation. Insurance afforded is primary and non-contributory. Separation of Insured endorsement. <br />City of Santa Ana <br />20 Civic Center Plaza <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 />ACURU 25 (201ot93) O 1968-2015 ACORD CORPORATION, All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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