TALLER SAN JOSE (6) - 2014 - Laserfiche WebLink

Home Browse Search

ORANCOU -19 VVXKUMAR3 .44c" R° CERTIFICATE OF LIABILITY INSURANCE DAT 'ODIYY Y) 2/11/11 /2014 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 Arthur J. Gallagher & Co. Insurance Brokers of CA., Inc. 505 N Brand Blvd, Suite 600 Glendale, CA 91203 CONTACT NAME: PHONE FAX Arc No E.t:(818) 539 -2300 AID,Ne, (818) 539 -2301 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC9 INSURERA : Groat American Insurance Company 16691 INSURED INSURER B: Nonprofits United INSURER C: Orange County Conservation Corps INSURER D 1853 N. Raymond Ave. Anaheim, CA 92801 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE DDLSUBR INSR MD POLICY NUMBER POLICY EFF MMIDDffYYY POLICY EXP MMIDD YYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERALLIABILITY CLAIMS -MADE I OCCUR X PAC5154680.08 7/20/2013 7/20/2014 PREMISES Ea occurrence $ 100,000 VIED EXP(Any one person) $ 5,000 X Professional $1M PERSONAL B ARV INJURY $ 1,000,000 X Sexual Abuse $1M GENERAL AGGREGATE $ 3,000,000 GENLAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG _ $ 3,000,000 POLICY PR LOC $ AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMIT Ea accident $ 5,000,000 BODILY INJURY (Per person) $ B X ANYAUTO 1888 71112013 7/1/2014 ALL OWNED SCHEDULED AUTOS AUT O S BODILY INJURY P idt (Per accident) ( ) $ _ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE PER ACCIDENT _ $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 FA X EXCESS ILIAD CLAIMS -MADE UMB560379506 8/17/2013 8/17/2014 RED X RETENTION$ 10,000 1 $ 1 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNEW YIN EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA NPU.WCG 001 -2014 111/2014 1/1/2015 WC STAID. 0TH TORY LIMITS- ER - E. L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is and alred) The City of Santa Ana its officers, employees, agents, volunteers and representatives are named additional insured with respect to the operations of the named insured. Endorsement to Follow. Workers Compensation coverage excluded, evidence only. Such insurance is Primary and Non - Contributory. t lI CERTIFICATE HOLDER CANCELLATION ty pitOYneY _ _ pssls ra SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE The City of Santa Ana 20 Civic Center Plaza l (Santa Ana. CA 92702_______ I�! J1LawJ ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD EXHIBIT I ON