HALCYON BEHAVIORAL ADMINISTRATORS (HALCYON BEHAVIORAL, LLC)

Home Browse Search

ACOR" CERTIFICATE OF LIABILITY INSURANCE 7/1/2024 DATE(MMIDDIYYYY) 4/11/2024 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 A 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(ies) must have ADDITIONAL INSURED provisions or 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 Lockton Insurance Brokers, LLC CONTACT NAME: CA License # OB99399 400 Capitol Mall Avenue, Suite 2600 Sacramento CA 95814 PHONE FAX Ext : A/C No E MAILo ADDRESS: (213) 689-0550 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Houston Casualty Compmy 42374 INSURED Simple Therapy, Inc. 1542844 Halycon Behavioral, LLC INSURER B: Scottsdale Insurance Compny 41 297 INSURER C : ironshore Specialty insurance Co 25445 INSURER D : 1080 Shaw Ave St 105 Fresno CA 93711 INSURER E INSURER F COVERAGES SIMTHOI CERTIFICATE NUMBER: 19715405 REVISION NUMBER: XXXXXXX 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYW POLICY EXP W MMIDD/YY LIMITS COMMERCIAL GENERAL LIABILITY NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX CLAIMS -MADE El OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ XXXXXXX MED EXP (Any one person) $ XXXXXXX PERSONAL & ADV INJURY $ XXXXXXX GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ XXXXXXX POLICY ❑ PRO ❑ LOC JECT PRODUCTS - COMP/OP AGG $ XXXXXXX $ OTHER: AUTOMOBILE LIABILITY NOT APPLICABLE EOa aBINEDccdentSINGLE LIMIT $ XXXXXXX BODILY INJURY (Per person) $ XXXXXXX ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ XXXXXXX PROPERTY DAMAGE Per accident $ XrXrXrXrXrXrXr HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $XXXXXXX UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ XXXXXXX WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE NOT APPLICABLE PER OTH- STATUTE ER E.L. EACH ACCIDENT $ XXXXXXX OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N I A E.L. DISEASE - EA EMPLOYEE $ XXXXXXX If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ XXXXXXX A E&O/Cyber N N H23TG33676-00 7/1/2023 7/l/2024 Agg/per claim $5M B Xs E&O/Cyber ESK3485033 7/1 /2023 7/l /2024 Agg/Per claim $5M B D&O/EPL/FTD EKS3521382 4/11/2024 4/11/2025 $1M/$1M/$1M C Mng Care E&O HC7CAB4HM9004 10/29/2023 10/29/2024 $1M Per Claim/$2M Agg DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Santa Ana is included as an additional insured on a primary non-contributory basis on the General, auto and Umbrella Liability policy as required by written contract. A Waiver of Subrogation applies to the City of Santa Ana with respect to the General, Auto, and Umbrella Liability policy as requited by written contract. 19715405 City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRC RA Mougmumt DMslcrn AUTHORIZED REPRESENTATIVE REVIEWED & APPROVED BY: 1® Risk Management Specialist © 1988-20.3 ACORD ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD