|
ACO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM;DDNYYY)
<br /> `...---- 03/01/2024
<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 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 /> PRODUCER CONTACT Kathleen McDermott
<br /> Bettis Insurance Services,Inc NAME:
<br /> ( (310)521 4480 FAX
<br /> PO Box 2816 A/C,NoExt) (AI �):
<br /> E-MAIL kathleen@bettisins.com
<br /> San Pedro CA 90731-0197 _ADDRESS:
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A Nonprofits Insurance Alliance of CA(A VIII Rated) 0
<br /> INSURED INSURER B:State Compensation Insurance Fund 35076
<br /> Shakespeare By The Sea INSURER C:
<br /> 515 N Prospect Ave.,Ste L 1 INSURER D:
<br /> Redondo Beach CA 90277- INSURERS:
<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 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 /> INSR TYPE OF INSURANCE ADDLI SUER POLICY EFF POLICY EXP
<br /> uisn wvn POLICY NLM.EER (MMIDDIYYYYI EMMIDD/YYYYI LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY X 2024-54378-NPO 03/01/2024 103/01/2025 EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR DAMAGE RENTED
<br /> PRFMI.SESO(Fa occurrence) $ 500,000
<br /> MED EXP(Any one person) $ 20,000
<br /> PERSONAL 8 ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000
<br /> X POLICY J, JET LOC PRODUCTS-COMP/OPAGG $ 3,000,000
<br /> OTHER $
<br /> A AUTOMOBILE LIABILITY X 2024-54378-NPO 03/01/2024 03/01/2025 !Fa aCOMBINEDccideDt}SINGLE LIMIT S 1,000,000
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED i X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY 1 AUTOS ONLY (Per accident)
<br /> 1 $
<br /> A I UMBRELLA LIAB X !OCCUR X 2024-54378-UMB 03/01/2024 03/01/2025 EACH OCCURRENCE $ 1,000,000
<br /> X EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1,000,000
<br /> DED RETENTION$ $
<br /> B WORKERS COMPENSATION X 9091718-2024 03/07/2024 03/07/2025 X j PEesuTE OOTH-
<br /> R—
<br /> AND EMPLOYERS'LIABILI Y f N TY 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
<br /> OFFICERtMEMBER EXCLUDED? N f A
<br /> (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ 1,000,000
<br /> N yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> A Improper Sexual Conduct X 2024-54378-NPO 03/01/2024 '03/01/2025 Each Occurrence 1 $1,000,000
<br /> General Aggregate $1,000,000
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS f VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> The Cityof Santa Ana,its officers,employees,a ents and volunteers are named as additional insuredsper endorsement CG2011 1219 where required
<br /> 9 q by
<br /> written contract with the named insured subject to the terms and conditions set forth in the policy.
<br /> Risk Management nim.mn
<br /> •
<br /> CERTIFICATE HOLDER • I a, r /.E CANCELLATION Al 000822
<br /> Ris`.r�lnnati.r
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Ana THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
<br /> Attn:Risk Management ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza
<br /> Santa Ana CA 92701- AUTHORIZED REPRESENTATIVE t..t..
<br /> d242( .....
<br /> t1. 41\
<br /> aNj"mu
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
|