Laserfiche WebLink
0 <br />• <br />OP ID: SH <br />ACC7?RD" CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) <br /> 09107/11 <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />949-253-8000 CONTACT <br />NAME; Shelly Hehner <br />Friedmann & Friedmann Ins Svcs <br />CA License #0759373 949-253-8009 <br />P"oNE 7-2641 F AIAXC, 1.): 949-253-8000 <br />A!G No Ext: _._.,.,.,.... ._., <br />3990 Westerly Place Suite 100 EMAIL <br />ADDRESS: shelly@Landfins.com <br />Newport Beach, CA 92660 <br />Laverne Friedmann PRODUCER <br />CUSTOMER ID #: LAURA-1 <br /> INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURED Laura's House INSURER A:Advantage Workers Comp <br />40517 <br />999 Corporate Drive, Suite 225 INSURER B <br />Ladera Ranch, CA 92694 . ....... --- <br />---- - <br /> INSURER C <br /> INSURER D : <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 /> <br />INSR ........... 1ADDL, SU-BR. _._- _ __........ _.. <br />LTR TYPE OF INSURANCE ! POLICY NUMBER -- - - - - <br />........ POLICY EFF POLICY EXP . <br />MM/DD/YYYY MM/DDIYYYY LIMITS <br />GENERAL LIABILITY <br />._ ;EACH OCCURRENCE $ <br />, <br /> <br />COMMERCIAL GENERAL LIABILITY X <br />OAKdACE T6R?FTiEp _ _ <br /> PREMISES (Ea occurrence) $ <br />CLAIMS-MADE !OCCUR, j ! MED EXP (Any one person) <br />y5 <br />1 .. __..--- <br />' 1. PERSONAL & ADV INJURY J $ <br /> GENERAL AGGREGATE 3 <br />GEN•L AGGREGATE LIMIT APPLIES PER. <br />! <br />- <br />PRODUCTS -COMP/OP AGG $ <br /> <br />POLICY !P <br />JECT RO- <br />LOC -........... ... <br /> <br />$ <br />!AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br />?_.. <br />(Ea accident) $ <br />ANY AUTO <br />- - <br />ALL OWNED AUTOS BODILY INJURY (Per person` .i $ <br /> <br />.._---- <br />t? BODILY INJURY (Per accident) $ <br />SCHEDULEDAUTOS ---- <br />? PROPERTY DAMAGE <br />$ <br />HIRED AUTOS (Per accident) <br />NON-OWNED AUTOS S <br /> <br />I UMBRELLA LIAR _ .j OCCUR j EACH OCCURRENCE <br />EXCESS LIAR CLAIMS-MADEI -AGGREGATE $ <br />--- <br /> <br />DEDUCTIBLE <br />i <br />RETENTION $ $ <br />WORKERS COMPENSATION <br />AND E <br />OYER <br />' WC STATU- OTH- <br />i X <br />I <br />T RY <br />MIT$ <br />I <br />MPL <br />LIABILITY <br />S <br />- <br />A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 13270747 <br />! OFFICERIMEMBER EXCLUDED? I N 1 A _ J <br />_ <br />ER <br />I <br />( <br />09/01/11 09101112 ? <br />I E, L. EACH ACCIDENT 5 UXI0,00 <br />(Mandatory In NH)! <br />E DISEASE •EA EMPLOYEE $ 1,000,000 <br />If yes- descnbe under <br />DESCRIPTION OF OPERATIONS below : ..._... -._.._.._... _. _-_. <br />E.L. DISEASE - POLICY LIMIT { $ 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) <br />RE: Emergency Shelter Grant Funds (ESG) <br />vcnr ?r??.e? i c nvcucn VAffl rLLA1IUN <br />CITYS-8 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana Community THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Development Department M-25 ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza, 6th FI <br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE <br />© 1988-2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD