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HomeMy WebLinkAboutCYS Liability Certificates for 2021-2022 DBH.pdf DATE(MM/DD/YYYY) ACORD� CERTIFICATE OF LIABILITY INSURANCE 1 11/16/2021 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 INSURERS), 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 CONTANAME: JOHNNY SEARCY SEARCY INSURANCE CENTER, INC. PHCNN E:t:800-736-3904 A/C Na:559-334-3442 15152 OAK RANCH DRIVE ADDRESS:SEARCY.INSURANCE GMAIL.COM VISALIA, CA 93292-9372 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:PHI LADELPHIA INDEMNITY INS CO 18058 INSURED INSURER B: COMPREHENSIVE YOUTH SERVICES OF FRESNO, INC. 4545 NORTH WEST AVE INSURERC: INSURER D: FRESNO, CA 93705-0946 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY �( COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X PHPK2235161 11/15/202111/15/202 DAMAGE TO RENTED CLAIMS-MADE � OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY [ I PE0 LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: $ A AUTOMOBILE LIABILITY X PHPK2235161 11/15/202111/15/202 COMBINED S INGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY Per accident $ A X UMBRELLA LIAB IX] OCCUR X PHUB788451 11/15/202111/15/202 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A SOCIAL SERVICES PHPK2235161 11/15/202111/15/202 AGG $3,000,000/EA OCC$1,000,000 PROFESSIONAL LIABILITY SEXUAL ABUSE LIABILITY PHPK2235161 11/15/202111/15/202 AGG$1,000,000/EA OCC$1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) COUNTY OF FRESNO, ITS OFFICERS,AGENTS AND EMPLOYEES ARE NAMED AS ADDITIONAL INSUREDS AS REGARDS A-18-366, A-18-687 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE COUNTY OF FRESNO, DEPT OF BEHAV HEALTH THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: MANAGED CARE STAFF ANANLYST ACCORDANCE WITH THE POLICY PROVISIONS. 1925 E. DAKOTA AVE FRESNO, CA 93726 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: COMMERCIAL GENERAL LIABILITY PHPK2235161 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: County of Fresno, its officers, agents and employees (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. Such insurance as is afforded is primary insurance and any other insurance shall be excess and not contribute to the insurance afforded by this endorsement. CG 20 26 11 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 0