ROJAS, ALICIA (4) - Laserfiche WebLink

Home Browse Search

A� O® CERTIFICATE I INSL'!��F�#Ilyll signe 6/08/zo23TYY) EOR I � E HOLD . THIS CERTIFICATE DOES NOT AFFIRMATIVELY NEGATIVELY AMEN XTEND OR ALTF RR H GEF BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT ONSTITUTE A CONTRA T 3ET1�C FHE 52RfF2S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICAT ..._ .., rt r •cam r.r_c—irrcarm IMPORTANT: If the certificate holder is an ADDITIO L t .ar t P�ya "AP�D^JI'�'''"'F1L9�NL�.D provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions ri tl,e policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu n5'such endorsements). PRODUCER Hiscox Inc. d/b/al Hiscox Insurance Agency in CA 5 Concourse Parkway Suite 2150 CONTACT NAME: Hit 007 ac No EMAIL R.E.ADDREscontact@hiscox.com INSURERS AFFORDING COVERAGE NAIC4 Atlanta GA, 30328 INSURER A: Hiscox Insurance Company Inc 10200 INSURED INSURER B Santa Ana Community Artist Coalition 1205 W Saint Gertrude PI INSURER C : INSURER D: Santa Ana, CA 92707 INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 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 SUER POLICY NUMBER POLICYEFF MMIDDIYYYY POLICYEXP MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE -UTPTT7OCCUR ETORENTED PREMISES Ea occurrence $ 100,000 X MED EXP (Any one person) $ 10,000 CGL is on BOP Form PERSONAL& ADV INJURY $ 0 A Y Y P101.174.712.1 01/23/2023 01/23/2024 AGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2,OOQ000 GEN'L X LOG POLICY JEo PRODUCTS-COMPIOP AGO $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ BODILY INJURY (Per pemon) $ ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident ( ) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ UMBRELLALIAB OCCUR BE EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED RETENTION$ $ WORKERS COMPENSATION PER OTH- ANDEMPLOYERS'LIABILITY Y/N ANYPROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? NIA STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) The City of Santa Ana, its officers, officials, employees and volunteers must be covered as additional Insured on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of the contract Including materials, parts, or equipment furnished in connection with such work or operations sub ject to policy terms and conditions. CERTIFICATE The City of Santa Ana, its officers, officials, employees and volunteers 1601 East Chesnut Ave SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Santa Ana, CA 92701 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE y WejeMwssgementDiviafan � R"rNuFn & APPROVED By. ©1988.2015 ACORD , , I x. &w=, ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD I I Rkk ManegementSpedA4t