ST. JOSEPH HEALTH SYSTEM 1 - 2016

Home Browse Search

STJOSEP -05 THURSTONJA acoizom CERTIFICATE OF LIABILITY INSURANCE `+-'� DATE(MMID V) 6/1/20115 5 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 Willis Insurance Services of California, Inc. c/o 26 Century Blvd P.O. Box 305191 NAME: certificates @willis.com PHONE (877) 945 -7378 arc No: 888 467 -2378 AIC No Ext : ( ) E'MAIL -ADDRESS: certificates @willis.com Nashville, TN 37230.5191 INSURER(S) AFFORDING COVERAGE NAICIt INSURERA:Safety National Casualty Corporation 15105 $ INSURED INSURER B $ INSURER C: MED EXP(Anyone person) St. Joseph Health System INSURER D: PERSONAL &ADV INJURY 3345 Michelson Drive, Suite 100 Irvine, CA 92612 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. HER LTR TYPE OF INSURANCE I SD NNE POLICY NUMBER POLICY POLICY YY LIMITS Santa Ana CA 92701.4637 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 17 OCCUR EACH OCCURRENCE $ PREMISES Ea occurrence $ GEN'LAGGREGATE MED EXP(Anyone person) $ PERSONAL &ADV INJURY $ LIMIT APPLIES PER: POLICY [7 PRO- JECT ❑ LOC OTHER: GENERALAGGREGATE $ PRODUCTS - COMPIOP AGO $ $ AUTOMOBILE LIABILITY ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Par accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEO RETENTIONS $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBEREXCLUOED2 (Mandatory in NH) If yes, d -scrhe under DESCRIPTION OF OPERATIONS below NIA LDS4052992 05/31/2015 05/31/2016 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,600,000 E.L. DISEASE - EA EMPLOYEE $ 1,600,000 E.L. DISEASE - POLICY LIMIT $ 1,600,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) (1 Re: Right of Entry Permit for property located at 203 -205 West Civic Center Drive, Santa Ana, CA, YMCA Building. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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 Santa Ana CA 92701.4637 CO/ ACORD 25 (2014/01) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD