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CERTIFICATE OF LIABILITY INSURANCE 1 DAT11/9/201188 ) 11/912 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 United Agencies, Inc. One Post, Ste. 200 Irvine CA 92618 United Fire INSURED UEK W ND -U Dekra-Lite Industries, Inc.; Lopez Living Trust 3102 W. Alton Ave Santa Ana, CA 92704 COVERAGES CERTIFICATE NUMBER: 66676626 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. LTR TYPE OF INSURANCE ISBBR POLICYEFF POLICY EXP -- SIN VES R WVD POLICY NUMBER (MMIODIYVYY) IMMIDDNWYI LIMITS A GENERAL LIABILITY V V 60504012 41612018 41812019 EACH OCCURRENCE $1,000,000 AUTHORIZED REPRESENTATIVE .- X COM MERCIAL GENERAL LIABILITY Santa Ana CA 92701 _TAVTGTTTFE TED PREMISES Ea occurrence $100,000 CLAIMS -MADE OCCUR MED RAP (Any one person) $5,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENLAGGREG�ATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $2,000,000 X POLICY F^ PEO FX] LOC $ A AUTOMOBILE LIABILITY Y Y 60504012 4/812018 4/812019 COMBINED SINGLE LIMIT (Es accident] $1 000 000 _ _ ✓ BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X NON -OWNED AUTOS HIRED AUTOS MX PROPERTY DAMAGE $ Per accident LeasedlReated Autos $100,000 X Deductible $1,000 A X UMBRELLA LIAB X OCCUR Y Y 60504012 418/2018 418/2019 EACH 01 CCUR_RENCE $2,000,000 AGGREGATE $2,000,000 EXCESS UAB CLAIMS -MADE DED RETENTION$ _ $ WORKERS COMPENSATION VJC STATU- OTH- AND EMPLOYERS' LIABILITY YIN L T ELEACH ACCIDENT $- , . ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIA -- (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below EL.DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Santa Ana and their respective officers, employees, agents, volunteers and representatives are to be specifically named and covered as Additional Insureds by the attached forms. Primary & Non -Contributory wording applies per the attached endorsement with Waiver of subrogation as required by written contract with the named insured. *Please note Copyright Laws apply to the Acord form prohibiting us from modifying the cancellation clause. However, per United Agencies, Inc. procedures we will notify you within 30 days if said policy cancels for any reason other than non-payment. In the event that the policies cancel for non-payment, you will be notified within 10 days. CERTIFICATE HOLDER CANCELLATION © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE .- Santa Ana CA 92701 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD