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SANDIEG-19 ORTPA1
<br /> ,dâ–ºcoRo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 1/23/2025
<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
<br /> NAME:
<br /> Fusco&Orsini Insurance Services,Inc. PHONE FAX
<br /> 5095 Murphy Canyon Road,Suite 200 (A/C,No,Ext):(858) 384-1506 No):(800)209-9298
<br /> San Diego,CA 92123 E-MAIL-ADDRESS:service@foagency.com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:All merica Financial Benefit Insurance Co 41840
<br /> INSURED INSURER B:The Hanover Insurance Company 22292
<br /> San Diego Centre For Organization Effectiveness INSURERC:Pie Insurance
<br /> 3914 Murphy Canyon Rd#A164 INSURER D:The Hanover Casualty Company 41602
<br /> San Diego,CA 92123
<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 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD MM/DD/YYYY MM/DD/YYYY
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR Z23J909524 12/7/2024 12/7/2025 DAMAGE TO RENTED 1,000,000
<br /> X X PREMISES Ea occurrence $
<br /> MED EXP(Any oneperson) $ 5,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY PRO LOC PRODUCTS-COMP/OPAGG $ Included
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000 000
<br /> Ea accident $
<br /> ANY AUTO X X AH3J928000 12/7/2024 12/7/2025 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br /> DED RETENTION$ $
<br /> C WORKERS COMPENSATION X PER
<br /> AND EMPLOYERS'LIABILITY STATUTE EERR
<br /> Y/N WCP11700351000 12/10/2024 12/10/2025 1,000,000
<br /> ANY PROPRIETOR/EXCLUDED?
<br /> R/EXECUTIVE N/A E.L.EACH ACCIDENT $
<br /> OF EXCLUDED? LyJ(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,U00
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> D Professional Liab LH3J91345900 12/7/2024 12/7/2025 Each Claim 1,000,000
<br /> D Professional Liab LH3J91345900 12/7/2024 12/7/2025 Aggregate 2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Santa Ana,its City Council,its officers,officials,employees,agents,&volunteers are named as an additional insured on the general liability &
<br /> business auto with waiver of subrogation and primary wording per the attached endorsements.Waiver of subrogation applies to the Workers Compensation.
<br /> APPROVED
<br /> By Tu Tran Nguyen at 12:33 pm,Feb 03,2025
<br /> CERTIFICATE HOLDER CANCELLATION
<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 /> Y ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza
<br /> Santa Ana,CA 92701
<br /> AUTHORIZED REPRESENTATIVE
<br /> 'A'V_t
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD Dig ita ne ly sigd by Tu Tran
<br /> Tu Tran Nguyen 9 yel
<br /> Date:2025.02.03 12:34:26-08'00'
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