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A��3/iCJ� CERTIFICATE OF LIABILITY INSURANCE <br />8130/2028DnYYYI <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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsements . <br />PRODUCER <br />James S. Bender Insurance Agency <br />515 W. Commonwealth Ave. Ste. 209 <br />Fullerton, Ca. 92832 <br />OD69973 <br />N NTACT <br />PHONE 1.888-725-4613 �r"X 714.770.0048� <br />IAo NqL.,.... <br />A15SJames+JSco Bro .rage.Com <br />INSURER AFFORDING COVERAGE <br />NAIC# <br />INSURERA.-PCIC RIG <br />INSURED Milli Low & Cheryl Dimson <br />Tab'le2Garden <br />12747 Barrett Lane <br />Santa Ana, Ca. 92705INSURPR <br />INSURER B! National Llabilley s PSia Ineuzenae company <br />IN URERC'Metropolitan Direct <br />INSURER D. •• <br />_—e.. <br />_ <br />RR <br />F <br />COVERAGES CERTIFICATF NI)MRFR. RP1/LCInKI Nil IRARGR: <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 BV THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAYHAVE BEEN REDUCED BYPAIDCLMMS, <br />LTR <br />TYPE OF INSURANCE <br />Nan <br />WVD <br />POLICY NUMBER <br />8,LICY EFF <br />xxpp <br />L IVyCyYY <br />LIMIT$ <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />s 1,000,000 <br />- e <br />`An rrson <br />s 50 000 <br />1f COMMERCIAL GENERAL LIABILITY <br />s 5 000 <br />CLAIMS -MADE r OCCUR <br />MEO P a <br />PERSONAL 6 ADV INJURY <br />3 1 000 000 <br />A <br />Y <br />Y <br />PCA5017-PC265602 <br />4/10/184/10/19 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GEN'L <br />AGGREGATE <br />LIMITAFF IES <br />PER: <br />PRODUCTS-COMPIOPAGG <br />s 1,00U,000 <br />X <br />POLICY <br />PRO <br />S <br />AUTOMOBILE LIABILITY <br />COa INEO INGL L-1 i' <br />1/000/ 000 <br />ANYAUTO <br />BODILYINJURY(Parperson)ALLOWNED <br />CAUTOS <br />SCHEDUAUTOSLED <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />I <br />Y <br />Y <br />CA027189P2018 <br />7/3/18 <br />7/3/19 <br />BODILY INJURY (ParacWnq <br />$ <br />R PE TY AMAQE <br />, De CE <br />$ $ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />C1c"11U MADE <br />BED 2ETENTIONs <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNERIEYEOUTWE ram; <br />fEMBER <br />OFFICERnEXCLUDED? LJ <br />(Mandatory in NH) <br />a fdescrnbe under D ROPERATIONS <br />T <br />N/A <br />Y <br />A9WC947004 <br />3/0/18 <br />3/8/19 <br />I WCSTATU I IOTH- <br />E.L.EACH ACCIDENT <br />$ 1/000/000 <br />EL DISEASE - EA EMPLOYEE <br />s 11()001000 <br />ICY I MIT <br />1 / DD / 000 <br />DESCRIPTIONOF OPERATIONSiLOCATIONS/VEHICLES(AaaoIIACORD TB1,Addlllonal Ranmmo SCM1etlule, it more apace is required) \\qq <br />The City of Santa Ana, it's officers, employees, agents, and representative are named as additioaa2P14orad. ,.-yj/9� <br />The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; it officers, employees, agents and �-{-�/ <br />representative are named as additional inaureda.The City of Santa Ana is also Primary 6 Nan -Contributory, <br />v,dCJ <br />including Waiver of Subrogation. With respect the additional insureds, this insurance shall not be c .qqe,, %,e ,.[L <br />or matarial Ly reduced in coverage or limits except after thirty (30) days written notice <br />City of Santa Are, 20 Civic Center Plaza, Santa Ana, California 92701. <br />The City of Santa Ana <br />20 Civic Center Plaza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Santa Ana, CA 92701 ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />01988-2.� ACORD CORPORATION. All rights reserved. <br />ACORD25 (2010/05) The ACORD name and logo are registered marks of ACORD _ <br />