FAMILIES TOGETHER OF ORANGE COUNTY

Home Browse Search

Dlguelly signed by Frandne R Francine R. Villareal YIIIa,eal Date: 2021.0810 I1 a 2:03 -D7'09 AC o� CERTIFICATE OF LIABILITY INSURANCE DATi(Z7izD" 1Y' 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 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(les) must 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 CONTACT Sandra COX NAME: Lake Insurance Agency PHONE E (714)263-3600 F NV: 19141 R63-360U 653 South Street E-MAIL sandra@lakeins.com ADDRESS: Lin #0747473 - INSURERS AFFORDING COVERAGE NAIC A INSURERA: The Hanover Insurance Company 22292 Tustin CA 92780 INSURED INSURER B:ERIPlCrYQrz Preferred Insurance Company 10346 INSURERC: Families Together of Orange County INSURERD: 661 W. list, #G INSURER E INSURER F: Tustin CA 92780 COVERAGES CERTIFICATE NUMBER:20-21 Master REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMEDABOVE FORTHE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 rypE OF INSURANCE ADDL SUBR . POLICYNUMBER POLICY EFF MMDO POLICY EXP MMIDINYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE ❑X OCCUR PREMISES DAMA ETOEaaooce: ccurecce $ 1,000,D00 MED EXP(Any one person) $ 10,000 X ZDIH10874802 11/6/2020 11/6/2021 PERSONAL B AOV INJURY $ 1,000,000 GEN-LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2,000,000 X POLICY PRO- JECT ❑ LOD PRODUCTS - COMPIOPAGG $ 2,000,000 $' OTHER: AUTOMOBILE LIABILITY COMBI NED SINGLE LIMIT Es accident) $ 1,000,000 BODILY INJURY (Per person) $ A ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS AWIE099975 11/6/2020 11/6/2021 I BODILY INJURY (Per accident) $ NON -OWNED HIREDAITOS AUTOS PROPERTY DAMAGE Per.(dent $ $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 4 000 000 AGGREGATE $ 4 000 000 A EXCESS LIAe CLAIMS -MADE OED X I RETENTION $ 30,000 1 $ UHIH423239 11/6/2020 11/6/2021 WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 B ANY PROPMETORIPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ (Mandatory In NH) If yes, describe under NIA EIG250255304 5/16/2021 5/16/2022 E.L. DISEASE -EA EMPLOYEE T $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space is required) The City of Santa Ana, its Officers, Agents Employees and Representatives are Additional Insured as respects general liability per CG 20 26 04 13. Coverage is primary and noncontributory per endorsement 421-2915 06 15. CERTIFICATE HOLDER CANCELLATION The City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 ACORD 25 (2014101) INS025 (201401) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Elie Toby/SANDRA 1n REVIEWED&APPROVED BY. ©1988-2014 ACORD C The ACORD name and logo are registered marks of ACORD RI Management Analyst