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HURLEY, PATRICK A. (3)
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HURLEY, PATRICK A. (3)
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Last modified
11/7/2023 7:24:04 AM
Creation date
9/13/2023 5:51:18 PM
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Contracts
Company Name
HURLEY, PATRICK A.
Contract #
N-2022-258-01
Agency
Parks, Recreation, & Community Services
Expiration Date
6/30/2024
Destruction Year
2029
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N-2022-258-01 <br />Samantha Digitally signed by <br />Samantha M. Lambert <br />I ® Udie: LUGL.IUU3 <br />AGOREI CERTIFICATE OF LIABILITY I iM .,V1o26:ai-o7-00� <br />DATE (MMIf)OryyYV) <br />Ds/1s/zozz <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 poltcypes) 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 />PRODUCER <br />BIBERK <br />P.O. BOX 113247 <br />Starn", CT 06911 <br />.NANT T . <br />AVN a 8 - 72-0 7 FNAC la • - <br />- Ao. customerserV Ce 7 BER (.Corn <br />WESSEL <br />INSURER1,91 AFFORDING COVERAGE <br />NAICM <br />_ �._—.._...__ <br />INSURER A: Berkshlre Hathaway Direct Insurance Company <br />ED <br />IPd�.7gtUgOUrlay <br />INSURERS: <br />INSURER C I <br />14920 Minneola Ct <br />Tustin, CA 927BO <br />INSURER D: <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 FDR 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 DESCRBED 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 />TYPEOFINSURANCE <br />D D <br />SWVD UER <br />POLICY NUMBER <br />POLICY EF <br />POLICY EXP <br />LIMITS <br />COMMERCIALGENERAL LIABILITY <br />CLAIMS -MADE ❑OCCUR <br />EACHOCCURRENCE <br />$ <br />PREN18Ee a • <br />$ <br />Mw EXP(Anyonaporsm) <br />$ <br />PERSONAL R AOV I NJURY <br />S ` <br />GEifL <br />AGGREGATE LIMIT APPLIES PER: <br />POLICYF] j�T DLOC <br />OTHER: <br />OENERALAOOn"ATE <br />$ <br />PRODUCTS-COMP/OPA00 <br />$ <br />$ <br />AInDMOBILELIABILIry <br />ANY AUTO <br />AUTOSONLY UT <br />UOS A)U <br />HIRED NON-OWJEU <br />AUTOS ONLY AUTOSONLY <br />COMDINEDSINGLEuNIT <br />accloo <br />$ <br />BODILY INJURY (Per parson) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY PAMAOE <br />1pft.,werm$ <br />UMBRELLA UAB <br />EXCESS LIAR <br />Lj <br />OCCUR <br />CLAIMS -MAD <br />_E_ <br />EACHCCCURRENCE <br />$ <br />AGGREGATE <br />g <br />DEC) r I RETENTION <br />_ <br />q <br />WORKERS COMPENSATION <br />ANOEMPLOYER&WABILITY YIN <br />ANYPROPRIETOR/PARTNEWEXECLJT1VE <br />OFfICER,MEMBEREXOLUDED7 <br />(Mandatory In NH) <br />DMIZIPTIONThe under <br />D• des ON under LITIO SUelav <br />NIA <br />P��EART, OERH- <br />- <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DIOEASE- EA EMPLOYDE <br />- <br />$ <br />E.L,DISEASE. POLICY LIMIT <br />$ <br />A <br />Professional Liability (Errors (k <br />Omissions): Claims -Made <br />X <br />NOPL738182 <br />ov/Oi/2aa2 <br />ns/oi/ao23 <br />Per Occurrence/ <br />Aggregate <br />$1,000,000/ <br />$1,000,000 <br />DESCRIP IoN OF OPERATIONS I LOOATIONS) VEHICLES (AOORO 101. Additional Remarke Schedule, maybe attached if more spacals required) <br />Clty of Santa Ana Risk Management Division is listed as addglonai Insured as I( pertains to professional liability (see endorsaine nt attached) <br />Sexual Molestatlon limits $250k <br />SHOULD ANY OF THE ABOVE D <br />City of Santa Ana Risk Management Division THE EXPIRATION DATE THE <br />20 Civic Center Plaza ACCORDANCE WITH THE POLIC <br />Santa Ana, CA 92702 AUTHORREDREFRESENTATNE <br />,� Auammle8pnau tARerrn <br />F REVIEWEDSMPROAtooll <br />�-"� Risk Manayemen[ SuPernisw <br />I,.,. �II�,�-•-. <br />©1988.2015 AC <br />ACORD 26 (2016103) The ACORD name and logo are registered marks ofACORD <br />CORPORATION. All rights reserved. <br />
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