ADR COACH, INC., THE - Laserfiche WebLink

Home Browse Search

ACC> CERTIFICATE OF LIABILITY INSURANCE DATE I MMIDDIYYYY) 02/13/2025 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 1S WAIVED, subject to the terms and conditions of the policy, curtain 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 CONTACT Burnette Insurance Agency, Inc. NAME: John A Burnette 3447 Lawrenceville Suwanee Rd. PHONNo,E (770) 339-8888 FAX (770) 339-1442 AC No; E-MAIL Suwanee GA 30024 ADDRESS: burnette@burnetteinsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Sentinel Insurance Company Ltd 11000 INSURED INSURER B:Hisaox Insurance Company Inc 10200 Angela Shaw the ADR Coach Inc. INSURERC: Coalition Insurance Company 29530 3782 Wellington Road INSURERD: Los Angeles CA 90016 INSURERE: (323) 810-0626 INSURER F COVERAGES BB CERTIFICATE NUMBER:cart ID 12919 (11) 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MMlDD1YYYY MMIDDffYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 2,000,000 DAMA E TO RENTE CLAIMS-MADE F1 OCCUR Y Y 20SBMBA6984 00/02/202408/02/2025 PREMISES Ea occurrence $ 1,000,004 MED EXP(Any one person) $ 10,000 PERSONAL&ADVINJURY S 2,000,000 GENI AGGREGATE LIMIT APPLIES PER GENFRALAGGREGATE $ 4,000,000 POLICY[:] PRO JECT ❑ LOC PRODUGTS-COMPIOPAGG $ 4,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Eaaccidenl $ 2,000,000 A ANY AUTO Y 20SBMBA6984 08/02/2024 OB/02/2025 BODILY INJURY(Per parson) S OWNED SCHEDULED BODILY INJURY(Per S AUTOS ONLY AUTOS ( ) HIRED NON-OWNED PROPERTY DAMAGE $ X X AUTOS ONLY AUTOS ONLY Par accident $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTIONS S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRiETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT S OFFICERIM EMBER EXCLUDED? NIA (Mandatory in NHI E.L.DISEASE-EA EMPLOYEE S it yes,descnho under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT S B Professional Liability MPL230875723 08/02/2024 DB/O2/2025Each Occurrence and S 1,000,000 Aggregate C Cyber Liability C-4MQ8-506868-CYBER-2024 08/29/2024 08/29/2025Rach Occurrence $ 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space is required) Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 and the Hired Auto and Non Owned Auto Endorsement SSO438, attached to this policy when a written contract is in place. Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008, attached to this policy when a written contract is in place. Notice of Cancellation will be provided in accordance with Form SS1223, attached to this policy when a written contract is in place. Coverage is primary and noncontributory per the Business Liability Coverage Form SSOODS, attached to this policy when a written contract is in place. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Human Resources Department 20 CIVIC CENTER PLZ AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD [APPROVED Page 1 of 1 By Luisa Najera at 1:46 pm,Feb 13,2025