2019/06/25 Down Syndrome Assoc. of Inland Empire Certificate of Liability InsuranceCERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDD/YYYY)
0612512019__.
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.
IMPUKIAN I: lithe 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 COHTA T
DFI - DiGerolamo Family Insurance Services PHONE
LugAnderson
2027 Hamner Ave 981 736-5335 Flies No : 981 735.3758
Norco, CA 92860 „AE REtss: iut:p@dfiinsurance.com _
License #: OD26889 INSURER(S) AFFORDING COVERAGE _ NAIC #
INSURED
Down Syndrome Assoc. of Inland Empire
INSURER C:
30295 Morse Rd
INSURER D :
Hemet, CA 92544
INSURER E :
INSURER F :
COVERAGES CFRTIFiC.ATFNIIMPtFR•
nnnnnnnn-9zaoia OCVIQInW SU IaaQOD. oT
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 CONTRACTOR 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
ILrRNSR TYPE OF INSURANCE ADDt 5UBR I POLICY EFF POLpomw LIMITS
POLICY NUMBER
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
y
2019-30708-NPO
06/25/2019
06/25/2019
EACH OCCURRENCE
$ 1 000 OOO
$ 600,09O
nAMMMA GME TO RE
PREMlqra4kzI rrencal
MED EXP (Any oneperson)
—
20,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
][ POLICY D PRO-
JECT LOC
GENERAL AGGREGATE
$ 2 00O 000
$ 2.000600
PRODUCTS - COMP/OP AGG
OTHER:
$
AUTOMOBILE
LIABILITY
COMBINdeED SINGLE LIMIT
aoCi
$
ANY AUTO
BODILY INJURY (Per person)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
$
BODILY INJURY Per accident )
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
'-- -
$
ROPE YDA(
PMAGE
per a
$
UMBRELLA LIAB OCCUR
EACH OCCURRENCE
$J-
EXCESS LIIAB CLAIMS -MADE
AGGREGATE
_
S
DED I I RETENT{ONS
$
WORKERS COMPENSATION
PER OTR-
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑
N / A
TAT T ER
$
— - —
E.L EACH ACCIDENT
E.L DISEASE - EA EMPLOYE
(Mandatory in NH)
If yes, describe under
$
E.L DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS below
5
I
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Cancelled
LANt rLLA I IUN
City Clerk SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City Of THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
tY Menifee ACCORDANCE WITH THE POLICY PROVISIONS.
29714 Hond Rd.
Sun City, CA 92586 AUTH0RIZEDREPRESENTATIVE
(D 1968-2015 ACORD CORPORATION. Ail rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Printed by LMA on June 25, 2019 at 03:36PM