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,►c'c Jvx:)r CERTIFICATE OF LIABILITY INSURANCE <br />A- zoig - 2-i3 <br />DATEIMMIDO/YYYY) <br />01)15/2019 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br />THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE <br />POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), <br />AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, <br />subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not <br />confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />HILL & USHER INS & SURETY/PHS <br />59302202 <br />NAME: <br />PHONE (866) 467-8730 <br />INC, No, Est): <br />FAX (888) 443-6112 <br />(AIC, No): <br />The Hanford Business Service Center <br />E-MAIL <br />3600 Wiseman Blvd <br />San Antonio, TX 78265 <br />ADDRESS: <br />INSURER($) AFFORDING COVERAGE NAIL# <br />Cl -AIMS -MADE OCCUR <br />INSURED <br />INSURER A: The Sentinel Insurance Company 11060 <br />PHOTOGRAPHY BY JOSHUA BOBROVE <br />INSURER 8: <br />2419 VISTA DEL CAMPO <br />INSURER C <br />SANTA BARBARA ,CA 93101-4662 <br />INSURER D <br />X General Liability <br />INSURER E: <br />INSURER F: <br />CnVFRAGFS CERTIFICATE NUMBER: REVISION NUMBER: <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 CONTRACT OR 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 <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSR <br />SUBR <br />WO <br />POLICY NUMBER <br />POLICY EFF <br />MMIDD/YYYY <br />POLICY EXP <br />MMIDO/YYYY <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />Cl 416`Q/') CG70ca+u <br />EACH OCCURRENCE $1,000,000 <br />Cl -AIMS -MADE OCCUR <br />DAMAGE TO RENTEDurrence $1,000,000 <br />PREMISE Ea occ <br />MED EXP (Any one person) $10,000 <br />X General Liability <br />A <br />X <br />59 SEW RV1649 <br />12/19/2018 <br />12/19/2019 <br />PERSONAL& ADV INJURY $1,000,000 <br />GEN'L AGGREGATE LIMITAPPLIES PER: <br />GENERALAGGREGATE $2.000,000 <br />POLICY ❑ ECT PRO- F LOC <br />PRODUCTS - COMP/OP AGO $2,000,000 <br />OTHER: <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT $1,000,000 <br />Ea accident) <br />BODILY INJURY (Per person) <br />ANY AUTO <br />A <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />59 SEW RVI 649 <br />12/19/2018 <br />12/19/2019 <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />(Per accident) <br />HIRED NON -OWNED <br />X AUTOS X AUTOS <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />AGGREGATE <br />EXCESS LIAR <br />CLAIMS- <br />MADE <br />DED <br />I RETENTION$ <br />WORKERS COMPENSATION <br />PER 0TH. <br />AND EMPLOYERS' LIABILITY <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />ANY YIN <br />PROPRIETORIPARTNEWEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />NIA <br />E.L. DISEASE -EA EMPLOYEE <br />tMandatory in NH) <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT <br />DESCRIPTION OF OPERATIONS below <br />CRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)se <br />F <br />usual to the Insured's Operations. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008, attached to this <br />y. <br />CERTIFICATE HOLDER <br />GANGELLA I ION <br />City Of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />220 S DAISY AVE <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br />SANTA ANA CA 92703-4334 <br />IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />Cl 416`Q/') CG70ca+u <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />ri <br />9 <br />V <br />