NAPHCARE, INC. (2) - 2017 - Laserfiche WebLink

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A� o® CERTIFICATE OF LIABILITY INSURANCE (MMIDD oAl2/28/2018 n 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 have ADDITIONAL INSURED provisions or 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 CONTACT NAME: Susan Crain VIG, LLC., dbafrhe Vestavia Group PNONE 205-552-0244 ac Ne: 205-244-8072 E4AA1L ADDRESS: 2090 Columbiana Road, Suite 2300 INSURERS AFFORDING COVERAGE NAIC0 INSURERA: Ironshore Specialty Insurance "A" XIV 14375 Birmingham AL 35216 INSURED INSURER B: The Travelers Insurance Company "A+" XV 19046 INSURER C: NaphCare, Inc. INSURER D: 2090 Columbiana Road, Suite 4000 INSURER E: INSURER F: Birmingham AL 35216 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. ILTR TYPE OF INSURANCE ADDL SUBR xm POLICY NUMBER POLICY EFF MM/DD POLICY EXP MWDD LIMITS X COMMERCIAL GENERAL ABILITY CLAIMS -MADE XI OCCUR EACH OCCURRENCE $ 1,000,000 DAMAGE (RENTED PREMISES (Eaoccurrence)$ 55,000 A N N #003886500 12/31/2018 12/31/2019 MEO IXP(Any one person) $ 5,000 PERSONALS ADV INJURY $ 1,000,000 GEWL AGGREGATE LIMIT APPLIES PER: GENERA -AGGREGATE $ 5,000,000 POLICY JET LOD PRODUCTS -COMPIOPAGG $ 1,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Me accident $ XXXXXX BODILY INJURY (Per person) $ ANY AUTO Not Applicable OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per aaitleni) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per eccitlent $ UMBRELLALUIB OCCUR Not Applicable EACH OCCURRENCE $ XXXXXX AGGREGATE $ XXXXXX EXCESS LIAR CLAIMS -MADE DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE OFFICERMIEMBEREXCLUDEDT l (Mandatory In NH) N/A N TC20-UB-9D896241-18 TRO-UB-9D896243-18 09/30/2018 09/30/2019 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 If yyes, describe antler DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 A Professional Liability Claims Made #003886500 12/31/2018 12/31/2019 Each Med. Incident 1,000,000 Professional Liability N N Ann. Aggregate 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Sohedule, maybe athched it more space is required) It is understood and agreed NaphCare, Inc, will name the City of Santa Ana as additional insured; also understood and agreed any material changes or modifications to the policy will require a thirty (30) day written notice to the County. NaphCare, Inc., will comply with the specifications of the Indemnity Agreement of the contract with the City of Santa Ana. I.3 r� 9 Chief of Police City of Santa Ana Santa Ana Police Department 60 Civic Center Plaza Santa Ana, CA 92702 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD