ORANGE COUNTY UNITED WAY (8) - Laserfiche WebLink

Home Browse Search

® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 4/14/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER (OC) Heffernan Insurance Brokers 18004 Sky Park Circle, Suite 210 Irvine CA 92614 CONTACT PHONE FAX • 949-771-3400 Alc Nei 949-771-3401 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: Philadelphia Indemnity Insurance Company 18058 License* 0564249 INSURED ORANCOU-05 INSURER B : Orange County's United Way 18012 Mitchell South INSURER C: INSURER D: Irvine CA 92614-6008 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 12483637 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR Me POLICY NUMBER POLICY EFF MM/DO/YYYY) POLICY EKE (MWDDfYYYYJ LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE MOCCUR Y PHPK2202136 11/l/2020 11/1/2021 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) $ 20,000 PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLI ES PER: PRO - X POLICY JECT F7 LOG OTHER: GENERALAGGREGATE $2,000,000 PRODUCTS - COMPIOP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PHPK2202136 11/1/2020 11/112021 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY I NJURY(Par person) $ Per eccitlent BODILY INJURY ( ) $ X PROPERTY DAMAGE Per accident $ $ A X UMBRELLALIAB EXCESS LIAR X OCCUR CLAIMS -MADE PHUB744991 11/1/2020 1111/2021 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DID X RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED9 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS be. N/A PER OTH- STATUTE ER EL. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 401, Additional Remarks Schedule, may be attached if more space is required) Re: Agreements With the City of Santa Ana. Cit� of Santa Ana, officers, agents, employees, representative and volunteers are included as an additional insured (primary and non-contributory) on General Liab Ilty policy per the attached endorsements, if required. Cancellation notice endorsement on the General Liability policy Is attached. This Certificate replaces and supersedes all previously Issued certificates. TE HOLDER City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 988.2015 ACORD CI ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD omw lUekhlknkgemenntDi�Mton REVIEWED &aAPPPIR,OV}ED BY.' 1 , i`i Y4SFlLAfF{ RnI Management Analyst