DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE
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).CONTACTPRODUCERNAME:FAXPHONE(A/C, No):(A/C, No, Ext):E-MAILADDRESS:INSURER(S) AFFORDING COVERAGE NAIC #INSURER A :INSUREDINSURER B :INSURER C :INSURER D :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 PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE 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.ADDL SUBRINSRPOLICY EFF POLICY EXPTYPE OF INSURANCE LIMITSPOLICY NUMBERLTR(MM/DD/YYYY) (MM/DD/YYYY)INSD WVDCOMMERCIAL GENERAL LIABILITYEACH OCCURRENCE $DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)MED EXP (Any one person) $PERSONAL & ADV INJURY $GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $PRO-POLICY LOC PRODUCTS - COMP/OP AGG $JECT$OTHER:COMBINED SINGLE LIMITAUTOMOBILE LIABILITY$(Ea accident)BODILY INJURY (Per person) $ANY AUTOALL OWNED SCHEDULEDBODILY INJURY (Per accident) $AUTOS AUTOSNON-OWNEDPROPERTY DAMAGE$HIRED AUTOS(Per accident)AUTOS$UMBRELLA LIABEACH OCCURRENCE $OCCUREXCESS LIABCLAIMS-MADE AGGREGATE $$DED RETENTION $PER OTH-WORKERS COMPENSATIONSTATUTE ERAND EMPLOYERS' LIABILITYY / NANY PROPRIETOR/PARTNER/EXECUTIVEE.L. EACH ACCIDENT $N / AOFFICER/MEMBER EXCLUDED?(Mandatory in NH)E.L. DISEASE - EA EMPLOYEE $If yes, describe underE.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS belowDESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)CERTIFICATE HOLDER CANCELLATIONSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.AUTHORIZED REPRESENTATIVE© 1988-2014 ACORD CORPORATION. All rights reserved.The ACORD name and logo are registered marks of ACORDACORD 25 (2014/01) AUTIS-1 OP ID: KD11/29/2023
ISU Insurance Services400 S Ramona Rd Ste 209Corona, CA 92879Agency Account 951-273-3000 951-273-3001United States Liability InsA++ SuperiorAutism Society Inland EmpireBeth Burt2638 Tundar CircleCorona, CA 92879A X1,000,000XXNBP1550535M 07/08/2023 07/08/2024 100,0005,0001,000,0002,000,000X Ded 01,000,000ANBP1550535M 07/08/2023 07/08/2024 X XAAbuse &Molestation NBP1550535M 07/08/2023 07/08/2024 $500K/$1MCity of Cathedral City is additional insured regarding our insured's generalliability. April 2024 Event. CITY687City of Cathedral City68-700 Avenida Lalo GuerreroCathedal City, CA 92234