Laserfiche WebLink
<br />Ejhjubmmz!tjhofe! <br />KINGCAU-01MCONTRERAS <br />DATE (MM/DD/YYYY) <br />cz!Bohjf! <br />CERTIFICATE OF LIABILITY INSURANCE <br />Bohjf! <br />3/8/2022 <br />Bdfwfep! <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 />Ebuf;!3133/14/25! <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />Bdfwfep <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />26;53;38!.18(11( <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 endorsement(s). <br />CONTACT <br />License # OD79617 <br />Magda Contreras <br />PRODUCER <br />NAME: <br />PHONEFAX <br />WBA Insurance <br />(562) 789-5704(562) 789-5804 <br />(A/C, No, Ext):(A/C, No): <br />13304 Philadelphia St <br />E-MAIL <br />magda@wbainsurance.com <br />Suite 200 <br />ADDRESS: <br />Whittier, CA 90601 <br />INSURER(S) AFFORDING COVERAGENAIC # <br />Philadelphia Indemnity Insurance Company18058 <br />INSURER A : <br />INSURED <br />INSURER B : <br />INSURER C : <br />Kingdom Causes dba City Net <br />4508 Atlantic Avenue, Ste 292 <br />INSURER D : <br />Long Beach, CA 90807 <br />INSURER E : <br />INSURER F : <br />COVERAGESCERTIFICATE 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 />INSRADDLSUBRPOLICY EFFPOLICY EXP <br />TYPE OF INSURANCEPOLICY NUMBERLIMITS <br />LTRINSDWVD(MM/DD/YYYY)(MM/DD/YYYY) <br />2,000,000 <br />A <br />COMMERCIAL GENERAL LIABILITY <br />X <br />EACH OCCURRENCE$ <br />DAMAGE TO RENTED <br />100,000 <br />CLAIMS-MADEOCCUR <br />X <br />PHPK23680781/11/20221/11/2023 <br />$ <br />PREMISES (Ea occurrence) <br />X <br />5,000 <br />MED EXP (Any one person)$ <br />2,000,000 <br />PERSONAL & ADV INJURY$ <br />4,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ <br />PRO- <br />4,000,000 <br />X <br />POLICYLOC <br />PRODUCTS - COMP/OP AGG$ <br />JECT <br />OTHER:$ <br />COMBINED SINGLE LIMIT <br />1,000,000 <br />A <br />AUTOMOBILE LIABILITY <br />$ <br />(Ea accident) <br />ANY AUTO PHPK23680781/11/20221/11/2023 <br />BODILY INJURY (Per person)$ <br />X <br />OWNEDSCHEDULED <br />AUTOS ONLYAUTOSBODILY INJURY (Per accident)$ <br />PROPERTY DAMAGE <br />HIREDNON-OWNED <br />XX <br />(Per accident)$ <br />AUTOS ONLYAUTOS ONLY <br />$ <br />UMBRELLA LIABOCCUR <br />EACH OCCURRENCE$ <br />EXCESS LIABCLAIMS-MADE <br />AGGREGATE$ <br />DEDRETENTION$ <br />$ <br />PEROTH- <br />WORKERS COMPENSATION <br />STATUTEER <br />AND EMPLOYERS' LIABILITY <br />Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. EACH ACCIDENT$ <br />N / A <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYEE$ <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ <br />Professional LiabiliPHPK23680781/11/20221/11/2023 <br />Claims Made/2mil agg2,000,000 <br />A <br />X <br />Sexual/PhysicalAbusePHPK23680781/11/20221/11/2023 <br />Or Molestation-Occur <br />A <br />X <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />10 Days Notice of Cancellation for non-payment/ 30 Days Notice other than non-payment- Coverage is Primary & Non-Contributory. Waiver of Subrogation <br />Included. <br />The City of Santa Ana, its officers, employees, agents, volunteers & representatives are named additional insured with respects to the <br />operations of the named insured per the attached CG20260413 endorsement. Such insurance is primary and non-contributory. <br />CERTIFICATE HOLDERCANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Division <br />20 Civic Center Plaza, 4th floor <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92701 <br />ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br /> <br />