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AC 00REP CERTIFICATE OF LIABILITY INSURANCE DATE) 6/26/20 8 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(les) 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). PRODUCER CONTACT Li Zette Ear as NAME: LJ PHONE (909) 987-7600 AXDN (909)987-7656 Amorelli, Roseman & Associates Insurance Services MAIL lizetteb@arainsurance.com ADDRESS: 3333 E Concours St Building 9-200 INSURERS AFFORDING COVERAGE NAIC# INSURERA:State COMP. Insurance Fund 35076 Ontario CA 91764 INSURED INSURERS, $ INSURER C: LIABILITY ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS Mdg Associates, Inc. INSURER D: INSURERE: COMBINED SINGLE LIMIT $ Ea eccldent 10722 Arrow Route Ste 822 INSURER F: PROPERTY DAMAGE $ Per accident Rancho Cucamonga CA 91730 COVERAGES CERTIFICATE NUMBER:18/19 WC 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 rypE OF INSURANCE LTR ADDL SUBR POLICY NUMBER POLICY EFF MMIDDIYYNX POLICY EXP MMIDD LIMITS GENL COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 71OCCUR SANA ANA, CA 92701 Lizette Bargas/JULIO U EACH OCCURRENCE $ DAMAGE TO R=I` PREMISES E o urr$ ence MED EXP (Any one person) $ PERSONAL &ADV INJURY $ AGGREGATE LIMIT APPLIES PER: POLICY PRO - ECT [j LOC OTHER: GENERAL AGGREGATE $ PRODUCTS-COMP/OPAGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT $ Ea eccldent BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident UMBRELLA LIAB EXCESS ILIAD OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED 7 RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN OFFICERIMEMBEANY PROPRIETORIPARTNEWEXECUTIVE ❑ A (Mandatory In NH�EXCLUDED? I( yes, describe under DESCRIPTION OF OPERATIONS below N/A 1980750-18 7/1/2018 7/1/2019 PER OTH- E I STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) PROOF OF INSURANCE FOR CITY OF SANTA ANA COMMUNITY DEVELOPMENT AGENCY. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) INS025 (901401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: TERRI EGGERS, SENIOR MGMT ANALYST ACCORDANCE WITH THE POLICY PROVISIONS. COMMUNITY DEVELOPMENT AGENCY AUTHORIZED REPRESENTATIVE 20 CIVIC CENTER PLAZA SANA ANA, CA 92701 Lizette Bargas/JULIO U ACORD 25 (2014/01) INS025 (901401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD