Laserfiche WebLink
A�® CERTIFICATE OF LIABILITY INSURANCE DADDIYYYY) <br /> o8/06/2r46rzD2s <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 /> Next First Insurance Agency,Inc. PHONE <br /> (855)222-5919 FAX <br /> PO Boy 60787 <br /> Palo Alto,CA 94305 E-MAIL ADDRESS: pp su ortnextinsurance.com <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURER : State Natioral Insurance Company,Inc. 12831 <br /> INSURED <br /> INSURER B <br /> Ivan Marquez <br /> Chanel Torrez city of Santa Ana risk management Division INSURER <br /> 20 Civic Center Piz <br /> Santa Ana,CA 92701 INSURER D <br /> INSURER E: <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER:740939636 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 EFF POLICY EXP <br /> LTR POLICYNUMBER MMlDDIYYYY MMlDDr^lYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000.00 <br /> CLAIMS-MADE a PREMISESS OCCUR DAMAGE ( RENTED Eaaccurrence) S1 O4,040.00 <br /> MED EXP(Any one person) s15,000.00 <br /> A X X NXT9W7H7TH-02-GL 10/07/2024 1OY0712025 PERSONAL&ADV INJURY S1,000,000.00 <br /> GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 52,004,000AG <br /> POLICY PROJECT LOC PRODUCTS-COMPIOPAGG S2,000,000.00 <br /> X <br /> OTHER_ S <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) S <br /> OWNED SCHEDULED AUTOS ONL AUTOS BODILY INJURY(Per accident) $ <br /> Y <br /> HIRED NON-OWNED PROPERTY DAMAGE S <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> S <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE S <br /> EXCESS LIAR H CLAIMS-MADE AGGREGATE S <br /> DIED RETENTIONS S <br /> WORKERS COMPENSATION PER OTH- <br /> STATUTE ER <br /> AND EMPLOYERS'LIABILITY Y 1 N <br /> ANYPROPRIETORIPARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT S <br /> OFFICERIMEMBEREXCLUDED? NfA - - <br /> (Mandatory in NH) E.L.DISEASE-£A EMPLOYEE S <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S <br /> f <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached if more space is required) <br /> The Certificate Holder is City or Santa Ana Parks,Recreation,and Community Services Agency.A General Liability Waiver of Subrogation applies in Favor of this Certificate <br /> Holder.City of Santa Ana,its City Council,offcers,officials,employees,agents and volunreers are an Additional Insured an the General Liaoility policy with respect to <br /> completed operations.This Certificate Holder is an Additional Insured on the General Liability policy with respect to ongoing operations.All Certificate Holder privileges apply <br /> only If required by written agreement between the Certificate Holder and the insured,and are subject to policy terms and conditions. <br /> Tu Tran °'gT{'Jl 'gneddr <br /> Tu Tran Nguyen <br /> Nguyen APPROVED <br /> By Tu Iran Nguyen at 4.35 pm,Aug Or,212� <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Santa Ana Parks,Recreation,and Community LIVE CERTIFICATE <br /> Services Agency — SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 20 Civic Center Piz THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Santa Ana,CA 92701 <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> Click or scan to view <br /> 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />