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FIVE ELEMENTS CONSULTING GROUP (MICHELLE BOOS-STONE) (2)
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FIVE ELEMENTS CONSULTING GROUP (MICHELLE BOOS-STONE) (2)
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Last modified
9/11/2024 2:08:58 PM
Creation date
9/11/2024 2:00:19 PM
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Contracts
Company Name
FIVE ELEMENTS CONSULTING GROUP (MICHELLE BOOS-STONE)
Contract #
N-2024-305
Agency
Parks, Recreation, & Community Services
Expiration Date
8/31/2025
Insurance Exp Date
10/25/2024
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11 °' CERTIFICATE OF LIABILITY INSURANCE <br />AC C?RI7 <br />- <br />GATE"1 YYYY) <br />01/23/2024 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br />THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE <br />POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), <br />AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, <br />subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not <br />confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />AUTO CLUB INSURANCE AGENCY LLC/PHS <br />72253682 <br />The Hartford Business Service Center <br />NAME: <br />PHONE (866)467-8730 <br />IAIC, No, Ezt): <br />FAX <br />(A/C, Nol: <br />3600 Wiseman Blvd <br />E-MAIL <br />San Antonio, TX 78251 <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE NAIC# <br />INSURED <br />INSURER A: Sentinel Insurance Company Ltd. <br />11000 <br />Five Elements Consulting Group LLC <br />INSURER B : <br />8100 E TOPIA ST <br />INSURER C : <br />LONG BEACH CA 90808-3339 <br />INSURER D <br />INSURER E <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: RFVIRION NUMRFR- <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 />INDICATEDA07WITHSTANDING 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 <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />1NSR <br />LTR <br />TYPE OF INSURANCE <br />ADOL <br />INSR <br />SUBR <br />MO <br />POLICY NUMBER <br />POLICY EFF <br />(MMII)DNYYYI <br />POLICY UP <br />MMIODIYWYI <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$1,000,000 <br />OCCUR <br />DAMAGE TO RENTED ncal <br />PREMISES <br />$1,000,000 <br />X <br />General Liability <br />y <br />MEO UP (Any one person) <br />$10,000 <br />A <br />X <br />X <br />72 SBM BF5602 <br />10/10/2023 <br />10/10/2024 <br />PERSONAL &ADV INJURY <br />$1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERALAGGREGATE <br />$2,000,000 <br />POLICY❑PRO. FX]Lac <br />JECT <br />PRODUCTS - COMPIOP AGE <br />$2A00,000 <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />ANY AUTO <br />BODILY INJURY Per <br />1 Parson) <br />ALLOWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) <br />HIRED NON-OWNEO <br />PROPERTY DAMAGE <br />AUTOS AUTOS <br />(Peraccident) <br />UMBRELLA LIAR <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$1,000,000 <br />A <br />EXCESS LIAR <br />CLAIMS - <br />MADE <br />SBM BF5602 <br />10/10/2023 <br />10/10/2024 <br />AGGREGATE <br />$1OnO,000 <br />IDEJ X <br />I RETENTION $ 10,000 <br />WORKERS COMPENSATION <br />PER <br />OTH- <br />ANDEMPLOYERTUABILITY <br />T TFR <br />ANY YIN <br />PROPRIETORIPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />NIA <br />E.L. EACH ACCIDENT <br />E.L DISEASE -EA EMPLOYEE <br />(Mandatory In NH) <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT <br />DESCRIPTION OFOPERATIONS below <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Those usual to the Insured's Operations. <br />Risk Management Division <br />20 CIVIC CENTER PI 7 <br />SANTA ANA CA 92701-4058 <br />ACORD 25 (2016/03) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br />IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />CJ rsd2tn o� LRO�i1.i.�cz_� <br />©1988-2015 ACORD CORI <br />The ACORD name and logo are registered marks of ACORD <br />luw.mmugarla¢ LT1.veR <br />REVIEWED & APPROVED BY: <br />Ruh Management An,dyft <br />
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