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"`MCERTIFICATE <br />OF LIABILITY INSURANCE <br />DATE(MMIDOrr" <br />THIS CERTIFICATE IS ISSUED AS <br />CERTIFICATE DOES NOT AFFIRM <br />MA <br />rIVE1.1i <br />R OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TH <br />11/6/2019 <br />CERTIFICATE HOLDER. THIS <br />BELOW. THIS CERTIFICATE OF I <br />SURAI <br />OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE <br />CE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE <br />AFFORDED BY THE POLICIES <br />REPRESENTATIVE OR PRODUCER, <br />kND Tli <br />ISSUING <br />E CERTIFICATE HOLDER. <br />INSURER(S), AUTHORIZED <br />IMPORTANT: If the certificate holds <br />is an <br />DDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED <br />provisions or be endorsed. <br />If SUBROGATION IS WAIVED, sublet <br />this certificate does <br />to th <br />terms and conditions of the Policy, certain policies may require an <br />endorsement. A statement on <br />not confer right <br />to the <br />ertificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Arthur J. Gallagher & Co. <br />CONTAC Edka SOk011k <br />77 <br />PNONE <br />818534-3558 <br />FAx x . 818.316.0990 <br />Insurance Brokers of CA, Inc. LIC <br />2629 <br />21820 Burbank Blvd. Suite 175 <br />EMAIL , Edka Sokolik a' <br />Woodland Hills CA 91367 <br />.corn <br />INSURED <br />Downey Vendors <br />6814 Suva Street <br />Bell Gardens, CA 90201 <br />COVERAGFS rebTrnrArc .rr r..rs,•... ..._.. .. _._ <br />THIS <br />INSR <br />IS TO CERTIFY THAT THE POLICI <br />NOTWITHSTANDING ANY <br />MAY BE ISSUED OR MA <br />AND CONDITIONS OF SUC <br />TYPE OF INSURANCE <br />X <br />S OF I <br />EOUIR <br />PERT <br />POLIC <br />ADDL <br />Y <br />SURANCE <br />MENT, <br />IN, <br />ES. <br />BRL <br />LISTED BELOW HAVE BEEN <br />TERM ORCONDITION OF ANY <br />THE INSURANCE AFFORDED BY <br />LIMITS SHOWN MAY HAVE BEEN <br />POLICY NUMBER <br />ISSUED TO <br />CONTRACTOR <br />THE POLICIES <br />REDUCED BY <br />PVUDCDYEFF <br />4/1/2019 <br />THE INSURED <br />OTHER <br />DESCRIBED <br />PAID CLAIMS. <br />FOLICOYEXPLIMBA YYYYj <br />Kt:VISIO <br />NAMEDN <br />DOCUMENT <br />HEREIN I <br />BOOVE ED I TjPOLICYIODINDICATED. <br />WITH RESPETHISCERTIFICATE <br />SUBJECT TMS,EXCLUSIONS <br />COMMERCIALGENERALUABILRY <br />CLAIMS.MADE�OCCUR <br />BKW56585014 <br />4/1/2020EACH <br />OCCU <br />RENCE <br />APREMI S <br />ewes ce <br />MED EXP <br />one arson <br />PERSONAL S <br />ADV INJURY <br />$1,000,000 <br />GEN1 AGGREGATE UMRAPPUES PER: <br />GENERALA <br />REGATE <br />$2,000,000 <br />A <br />X JPERR1:1 LOC <br />POLICY <br />OTHER: <br />AUTOMOBILE LIABILITY <br />X ANY AUTO <br />BAW56585014 <br />4/1/2019 <br />4/1/2020 <br />PRODUCTS- <br />OMP/OPAGG <br />$2000000 <br />COMBINERS <br />NGLEUMIT <br />$ <br />$1,000,000 <br />Y(Per person) <br />$ <br />OWNED <br />AUTOSONLY AUTSCHO$EDULEO <br />AUT <br />X HIRED X NONONMED <br />AUTOS ONLY AUTOS ONLY <br />BODILY INJU <br />BODILY INJU <br />Y (Por ecGdenl) <br />s <br />PROPS Ee D <br />AGEiftr <br />E <br />RENCE <br />E <br />$10.000,000 <br />B <br />X UMBRELALVU! X OCCUR <br />EXCESS LIAR ClA1Ms-MAD <br />USA56586014 <br />4H/2019 <br />4/72020 <br />EACH OCCU <br />DED X RETENTION$ <br />AGGREGATE <br />S10,000,000 <br />WORKERS COMPENSATION <br />E <br />AND EMPLOYERS' LIABILITY YIN <br />ANYPROPRIETORIPARTNERIEXECUTNE <br />OFFICERIMEMBEREXCLUDED9 <br />(Mendatery In NMI <br />NIA <br />I STATUTI <br />ERµ <br />E.L. EACH ACCIDENT <br />$ <br />E.L DISEASE <br />EA EMPLOYEE <br />E <br />byes, describe antler <br />DESCRIPTION OF OPERATIONS below <br />E.LDISEASE <br />SI,= <br />E1,000 <br />POLICYLIMIT <br />S <br />A <br />HIrsd AV PD <br />CoUelon Dee. <br />BAW56585014 <br />4/1/2019 <br />4/1/2U20 <br />DESCRIPTION OFOPERATIONS ILOCATIONSIVEHI <br />City of Santa Ana, Risk Management, it's <br />General Liability coverage on a primary an <br />U:S'AC <br />fOcels, <br />non c <br />D 101,AddItlonal Remarks B .dule,rsaybeH .hedXrsoreapece lerago.d) <br />mployees, agents, representatives, and volunteers are included as Additio <br />ntdbUtory basis per attached form CG 88100413. 30 days Notice of Cancel <br />al Insureds with respect to <br />allon Applies. <br />R VIE <br />& APPROVED <br />CERTIFICATE HOLDER MAKISK <br />MANVIGEMENT <br />UIVISIUN --Z=.._.. -_.__. <br />V 13 2019 SHOULD ANY OF THE ABOVE DESCRIBED <br />THE EXPIRATION DATE THEREOF, Ni <br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISII <br />Risk Management M. LAMBERT <br />20 Civic Center PI AUTHGRIZEDREPRESENTATWE <br />Santa Ana CA 92702 <br />/jiYr �t• <br />avv-Av rO qt, <br />ACORD 25 (2016103) TheACORD name and logo are registered marks of ACORD <br />ES BE CANCELLED BEFORE <br />WILL BE DELIVERED IN <br />rights <br />