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ORANGE COUNTY UNITED WAY (8)
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ORANGE COUNTY UNITED WAY (8)
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Last modified
4/22/2021 11:32:26 AM
Creation date
4/22/2021 11:28:37 AM
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Contracts
Company Name
ORANGE COUNTY UNITED WAY
Contract #
A-2021-048
Agency
Community Development
Council Approval Date
4/6/2021
Expiration Date
6/30/2021
Insurance Exp Date
10/1/2021
Destruction Year
2026
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Francine R. Dlyttally signed by flznaloeR <br />ollsool <br />T VIIIpICQI <br />ua p ,5"5 3' ' p <br />A CERTIFICATE OF LIABILITY INSURANCE <br />IliAcctik', 2402345 <br />DATE(MMIDDIYYYY) <br />4/14/2021 <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. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain .policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />LOCkton Companies, LLC <br />3657 Briarpark Dr., Suite 700 <br />Houston, TX 77042 <br />CONTACT 888-628-8365 <br />PHONE FAX <br />A/c No: <br />E-MAIL <br />ODRE55: <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURER A; Ace American Insurance Co. <br />22667 <br />INSURED <br />ORANGE COUNTY'S UNITED WAY <br />INSURER B; <br />INSURER C ; <br />ORANGE COUNTY UNITED WAY <br />18012 MITCHELL S <br />IRVINE, CA 92614.6008. <br />INSURER 0: <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 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 <br />TYPE OF INSURANCE <br />ADDL <br />IRM <br />SUER <br />POLICY NUMBER <br />POLICY EFF <br />MMIDD/YYVY <br />POLICY EXP <br />MM/ODIYYYYI <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />EACH OCCURRENCE <br />$ <br />DAMAGE TORENTED <br />PREMISES Eaoccurrence <br />$ <br />GEN'L <br />MED EXP(Any one person) <br />$ <br />PERSONAL B ADV INJURY <br />$ <br />AGGREGATE LI MIT APPLIES PER: <br />POLICY JEOT LOC <br />OTHER: <br />G ENERAL AGGREGATE <br />$ <br />PRODUCTS - COMP/OPAGG <br />$ <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ <br />BODILY INJURY (Par parson) <br />$ <br />BODILY INJURY Per aciident <br />( ) <br />$ <br />PROPERTY DAMAGE <br />Pereccident <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAR <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED RETENTION$ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY Y/N <br />ANY PROPRIETORIPARTNEIVEXECUTIVE ❑ <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />C68751949 <br />1071 /2020 <br />1011/2021 <br />PER OTH- <br />X STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />E.L. DISEASE -POLICY LIMIT <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) <br />HEAP Suboartrector Agreement with Orange County United Way for Landlord Incentive Program for Foster Youth to <br />Independence Housing Voucher Holders <br />CERTIFICATE HOLDER <br />CITY OF SANTA ANA <br />RISK MANAGEMENT DIVISION <br />20 CIVIC CENTER PLAZA <br />SANTA ANA , CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br />IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />d ma., KWXMAnB$YlNelit UlNelon <br />3'"%� ,�i ggREVIEWED&(pA�P+P+,R,O/VAEOBYgp: <br />MI <br />'� Risk Managereem Analyst <br />
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