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NATI'S HOUSE (NEUTRAL GROUND)
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Last modified
8/24/2022 2:18:27 PM
Creation date
12/5/2018 10:27:11 AM
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Contracts
Company Name
NATI'S HOUSE (NEUTRAL GROUND)
Contract #
N-2018-141-01
Agency
Parks, Recreation, & Community Services
Expiration Date
8/31/2018
Destruction Year
2023
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nc E)" CERTIFICATE OF LIABILITY INSURANCE <br />OAT <br />0513U131120YYYY) <br />110 <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 AMENb, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, <br />IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED, the pollcy(los) must be endorsed. If SUBROGATION S WAIVE , au )oat to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />NAA �—n <br />Automatic Data Processing Insurance Agency, Inc. <br />P .No x1 .._.___ tgrc N� o), —�_ <br />1 Adp Boulevard <br />AoORIESIll <br />Roseland, NJ 0706E <br />INSURER(S) AFFORDING COVERAGE <br />_ <br />NAICa <br />INSURERAI State Campenaailan lneumnca Fund <br />35076 <br />INSURED <br />INSURERS; <br />NEUTRAL GROUND <br />—'- <br />1733VALENCIA <br />INSURERD: <br />Santa Ana, CA 02706 <br />INSURERS: _ <br />INSURER F1 <br />COVERAGES CERTIFICATE NUMBER: VMS/ REVISION NUMBER <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM) OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS S14OWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />ILm <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />N1Ai DID I <br />I me I <br />LIMITS <br />COMM@RCIAL a@N@flAL LIABILITY <br />CtAIM15-MADE ❑OCCUR <br />EAAR <br />$ <br />_ <br />PR DAMAGE TORENTED <br />(go ecamareal$ <br />MET EXP (Any ona perean) <br />$ <br />PERSONAL ADV INJURY <br />$ <br />GENIL AGGREGATE LIMIT APPLIES PER <br />POLICY'PELT ❑LOC <br />OTHER: <br />GENERALAGGREGATE <br />$ <br />PRODUCTS •COMP/OP AGO <br />$ <br />$ <br />AUTOMOBILE <br />LIASILRY <br />ANY AUTO <br />AViOS NED SCHEDULED <br />HIREDAUTOS AUTOBWNtD <br />SOGILYINJURY(Perperapn) <br />$ <br />BODILY IWURY(Par accident) <br />$ <br />Per ncclCeiR AMq(iE <br />$'.',' <br />$ _ <br />UMDRELLA LIAR <br />EXCESS LIAO <br />OCCUR <br />CUNMIS-MADE <br />EACHOCCURRENCE <br />$ <br />AGGREGATE <br />S <br />DEO <br />I I RETFNTION$ <br />$ <br />A <br />WORK@RS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY <br />OFFIC@FIMEN9EH EXCLUDED? �Y <br />(Mandatary In NH) <br />IUer <br />s IPTiON OF OPERATIONS Mim, <br />NIA <br />N <br />9221268.2017 <br />ii(13121117 <br />11113/2018 <br />X I TATVTE I I ER <br />B.L. BncH ACCIDENT <br />$ 1,000,000 <br />E,L. DISEASE - EA EMPLOYEE1 <br />$ 1,000,000 <br />EL.DISEASE-POU11YUMIT <br />5 1,000,000 <br />DESCRIPTION OF OPERATIONS l LOCATIONS I VEHICLESIACORD 191, AddIdanel RemarksSahudule, may he attached It MOM apace Is COMOrad) 1 <br />N ' <br />c� <br />V MI ICLI.M 11 V N <br />SHOULD ANY OF HE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE <br />Cityof Santa Ana <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Attn: Torrl Eggers <br />ACCORDANCE WITH THE POLICY PROVISIONS, <br />20 CIVIC Canter Plaza <br />AUTNGRIZEO REPRESENTATIVESanta <br />91 `� <br />Ana, CA 92701 <br />©1988.2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />
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