AUTIS-1 OP ID: KD
ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 01/07/2025
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 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 endorsements).
NAME:
SU Insurance Services PHONE
400 S Ramona Rd Ste 209 (ANC, No. Ext): 951-273-3000 (AC, No): 951-273-3001 Corona, CA 92879 E-MAIL
ADDRESS:
Agency Account
INSURERS) AFFORDING COVERAGE NAIC #
INSURERA: United States Liability Ins 28595
INSURED Autism Society Inland Empire INSURER B: A++ Superior Beth Burt
INSURER C:
2638 Tundar Circle
Corona, CA 92879 INSURER D:
INSURER E:
INSURER F:
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 LIMITS
LTR TYPE OF INSURANCE
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR x 01550535N 07/08/2024 07/08/2025 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 $ 2,000,000 PRO-
X POLICY JECT LOC PRODUCTS - COMP/OP AGG $
OTHER: Ded 0
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
(Ea accident) 1,000,000
A ANY AUTO NBP1550535N 07/08/2024 07/08/2025 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS
X HIRED AUTOS NON-OWNED PROPERTY DAMAGE $
AUTOS (Per accident)
UMBRELLA LIAB OCCUR EACH OCCURRENCE
EXCESS LIAB CLAIMS-MADE AGGREGATE
DED RETENTION S
STATUTE
Y / N
E.L. EACH ACCIDENT $
N/ A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT S
Abuse &Molestation NBP1550535N 07/08/2024 07/08/2025 $500K/$1M
CERTIFICATE HOLDER CANCELLATION
CITY687
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
ACCORDANCE THE POT ROOSE NOTICE WILL BE DELIVERED IN
City of Cathedral City
68-700 Avenida Lalo Guerrero
Cathedal City, CA 92234 AUTHORIZED REPRESENTATIVE
SisteDele
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