SOUTHERN CALIFORNIA INDIAN CENTER (2)

Home Browse Search

SOCALIF-01 HBCT10 ,4?rrr? CERTIFICATE OF LIABILITY INSURANCE //20/220/2 oATDIYYYY) - 012 6 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 be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain 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 License # 0564249 CONTACT NAME: (WC) Heffernan Insurance Brokers , PHONE 1 (925) 934-8500 arc No : 1 (925) 934-8278 c No Ext '1350 Carlback Avenue E-MAIL CA 94596 Walnut Creek ADDRESS: , INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Non Profits Insurance Alliance of California 011845 _ INSURED INSURER B: North American Elite Insurance Company So. California Indian Center INSURER C: Paula Starr, Director INSURER D 10231 Slater Ave. Ste. 112 CA 92708 lle i V F t INSURER E : n a y, oun a INSURER F : i CERTIFICATE NUMBER: REVISION NUMBER: COVERAGES _ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED . 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 LTR TYPE OF INSURANCE IN R WVD POLICY NUMBER MMLDDY/YYYY MM/DDY/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY 201101698NPO 71112011 71112012 PREMISES Ea occurrence $ 500,000 CLAIMS-MADE I X-1 OCCUR MED EXP (Any one person) $ 20,000 X Sexual Abuse Inc[ PERSONAL & ADV INJURY $ 1,000,000 X Misc Professional GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PEOT- r LOC Emp Ben. $ 1,000,000 SINGLE LIMIT O ABINED 000 000 1 AUTOMOBILE LIABILITY t E $ , , A X ANY AUTO 201101698NPO 71112011 71112012 BODILY INJURY (Per person) $ ALL OWNED T S SCHEDULED AUTOS BODILY INJURY (Per accident) $ AU O NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS X AUTOS Per accident UMBRELLA LIAR CCUR EACH OCCURRENCE $ 4,000,000 A T EXCESS LIAR LA IMS-MADE 201101698UMBNOP 71112011 71112012 AGGREGATE $ 4,000r000 DED X RETENTION $ 10,000 $ WORKERS COMPENSATION WC STATU- OTH- T RY LIMIT ER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ ? OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B Crime CWB00011430901698 71112011 71112012 Empl Dish 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space ' VW V Project: As on file with the insured. To .APpR?VE? RC r??ey A E' S?? LIS ttO ta?t City gssis - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Santa Ana Youth Council ACCORDANCE WITH THE POLICY PROVISIONS. Workforce Investment Board Bl it 200 d S 1000 E. Santa Ana v ., u e Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD