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AC E) CERTIFICATOF LIABILITY INSURANCE <br />°A�'5/2018 <br />OB/25/2078E <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. Astatement on <br />this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). <br />PRODUCER <br />CONTACT Dianna Mahn <br />NAME: <br />All -Cal Insurance Agency <br />"ON' Ex : (916) 784.9070 /wc NPI: (918) 784-0 558 <br />505 Vernon Street <br />ADDRESS: dianna@all-calinsurance.com <br />INS_URER(SIAFFORDING COVERAGE <br />NAICM <br />Roseville CA 96678 <br />INSURERA: Nonpro8(einsurance Alliance of California <br />011845 <br />INSURED <br />State Compensation INSURERS: pe sation Insurance Fund <br />35076 <br />The Los Angeles Dream Shapers <br />INSURER C: <br />P.O. Box3837 <br />INSURER D: <br />INSURERS: <br />Orange CA 92865 <br />INSURERF: <br />CERTIFICATE NUMBER: CL <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ww <br />LTR <br />TYPE OF INSURANCE. <br />INSD <br />WVO <br />POLICYNUMBER <br />POUC EF <br />lmmmoIYYYY <br />MMIDDYYYY <br />LIMITS <br />ERCIALGENERAL DABILTYEACHOCCURRENCE <br />S 1,000,000 <br />=XCLO]AE-Ar <br />LUMS-MADE Z OCCUR <br />PREMISES Ea orr Reece <br />5 500,000 <br />MEOEXP(My one person) <br />S 20,000 <br />liability <br />$1,000,000/1,000,000 <br />PERSONAL a AOV INJURY <br />5 1.000.000 <br />A <br />Y <br />2018-08609NPO <br />06/13/2018 <br />06/13/2019 <br />AGGREGATE LIMIT APPLIES PER: <br />GENERALAGGREGATE <br />S 2,000.000 <br />GEN'L <br />X <br />POLICY PET <br />LOC <br />PRODUCTS-COIAPIOPAGG <br />3 2,000.000 <br />S <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMmNEO IN LELIMIT <br />Ea a dtlent <br />SI 0000,000 <br />BODILY INJURYIPer person) <br />S <br />ANYAVTO <br />A <br />OYPIED SCHEDULEO <br />AUTOS ONLY AUT <br />2018-08609NPO <br />06113/2018 <br />06/ <br />13/2019CSIMUURY(PIl.mdent <br />­BODILYS <br />) <br />HIRED x NON OWNED <br />X <br />AA E <br />AUTOS ONLY AUTOS ONLY <br />Per ecddent <br />S <br />Comp/Coll deductible <br />5 500 <br />UMBRELLA DAB <br />OGCUR <br />EACHOCOURRENCE <br />S <br />AGGREGATE <br />S <br />EXCESS LIAR <br />CLAIMS -MADE <br />DED <br />I I RETENTION 5 <br />S <br />WORKERS COMPENSATION <br />H_ <br />AND EMPLOYERS' LIABILITY YIN <br />x STATUTE ER <br />E.L. EACH ACCIDENT <br />S 1,000,000 <br />B <br />ANY PROPRIETORRARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? ❑ <br />N/A <br />9015327-18 <br />06/06/2018 <br />- <br />06/06/2019 <br />EL DISEASE -EA EMPLOYEE <br />S 1000,000 <br />(Mandatory In NH) <br />H yes, describe <br />E.L. DISEASE -POLICY LIMIT <br />S 11000,000 <br />DESCRIPTION OF OF O OPERATIONS bnlav <br />DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES IADDR0101, Addilionel Remarks Schedule, may be aaacnedVmore space is required) <br />`I <br />The City of Santa Ana, its officers, agents, employees and volunteers are named additional insured under their Contract terms. Coverage is #aty and <br />non -Contributory and Form CG 20 26 applies P <br />SHOULD ANY OF THE ABOVBTTESCRIBE ES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTIC WILL BE DELIVERED IN <br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92701 ,I �),,,,till�. <br />91988-2015 ACORD CORPORATION. A711thtS reserved. <br />AUURU Z5 (ZU15/U3) The ACORD name and logo are registered marks ofACORD <br />