Laserfiche WebLink
A r^ C>R j"1ro <br />/iLf✓ Lf CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMIDD(YYYY)3/31/2.017 <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 pollcy(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 ICA Insurance Services <br />130 Yantis, Suite 250 <br />Aliso Viejo; CA 92656 <br />CONTACT <br />NAME: Betty Tran <br />PACNNe Ex : 949-297-5962 APic No: 949-297-5960 <br />EMAIL <br />ADDRESS: bett .tran ioausa.com <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURER A: RLIInsurance Company <br />13056 <br />www.ioausa.com CA License#OE67768 <br />INSURED <br />Johnson -Frank & Associates, Inc. <br />5150E. Hunter Avenue <br />INSURER B : <br />INSURERC: <br />INSURERD: <br />Anaheim CA 92807 <br />INSURER E : <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 34940693 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 />INTR <br />TYPE OF INSURANCE <br />ADDL <br />SUER <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDIY1'YY <br />POLICY EXP <br />MMIDDIYY <br />LIMITS <br />A <br />COMMERCIALGENERALLIABILITY <br />CLAIMS -MADE 71/ OCCURScheduled <br />Prim/NonCon <br />�/ <br />`/ <br />PSB0001301 <br />Al Endt <br />#PPB <br />Professsionalional 2 Services <br />12/1/2016 <br />12/1/2017 <br />EACHOCCURRENCE <br />1,000,000 <br />DAMAGE TO RENTED <br />P EMISES Ea occurrence <br />_$ <br />$ 1,000,000 <br />✓ <br />MED EXP (Any one person) <br />$ 10,000 <br />✓ <br />Wvr of Subr <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />performed by the Insured <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY 0 PRO ✓ LOC <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />are Excluded <br />PRODUCTS -COMP/OP AGG <br />$ 2,000,000 <br />$ <br />OTHER: <br />A <br />AUTOh1081LELIA81LI7Y <br />�/ <br />✓ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />NONOWNEDvr <br />AUTOS ONLY ✓ AUTOS ONLY <br />✓ <br />✓ <br />PSA0001078 <br />Designated Insured Endt <br />#CA20481013; Prim/NonCon <br />and Blkt Wvr Subr <br />o <br />Included on pg 2 of Form <br />12/1/2016 <br />12/1/2017 <br />EaaccidentSINGLELIM)T <br />$ 11000,000 <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />— <br />$HIRED <br />EcRdT nDAMAGE <br />Par SPo <br />$ $Prim/NonCon <br />$ <br />✓ Wvr of Subr <br />#PPA3000313 <br />A <br />UMBRELLA LIAB <br />kl/ <br />OCCUR <br />PSE0001230 <br />12/1/2016 <br />12/1/2017 <br />EACH OCCURRENCE <br />$ 4000000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />Excludes Professional Liability <br />AGGREGATE <br />$ 4,000,000 <br />DED RETENTION$ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANYPROPRIETORIPARTNERlEXECUTIVE <br />OFFICERlMEMBEREXCLUDE01 <br />NIA <br />�/ <br />PSW00022`J8 <br />Waiver of Subrogation <br />Endt#WC0403060484 <br />12/1/2016 <br />12/1/2017 <br />�/ SERRRITE ER <br />_ <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />(Mandatory in NH} <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$ 1,000,000 <br />A <br />Professional Liability <br />RDP0027023 <br />12/1/2016 <br />12/1/2017 <br />$2,000,000 Each Claim <br />Claims -Made <br />$2,000,000 Aggregate <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required) <br />Certificate Holder is an Additional Insured with respect to General Liability (GL) and Automobile Liability but only when required by written contract <br />with the Insured prior to an occurrence as per Endorsements noted above. GL includes Separation of Insureds and Contractual Liability per limitations <br />In the BusinessOwners' Coverage farm. A Workers' Compensation Waiver of Subrogation as noted above is included for the person or Organization named <br />in the Schedule that are parties to a contract requiring this Endorsement, provided that contract Is executed before the loss. Coverage subject to all <br />policy terms, conditions, limitations and exclusions. 30 Day Notice of Cancel/10 Days for Non -Payment in accord nca with policy provisions <br />RE71' UVE:D BY: _. EUNlCi= HEREDIA (PG OF5 a l <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana, its officers and employees <br />City of ants M-36 <br />PO Santa Ana 8 -36 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />�v <br />(AVC) Alicia K. Igram <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />34940693 112/16-17 GL/AUTO/EXCESS/WC/PL I (AVC) Tina Shapiro 13/31/2017 11:51t45 AM (PDT) I Paqe I of 9 <br />