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A� Ror CERTIFICATE OF LIABILITY INSURANCE
<br />01ioii2o s '
<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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the
<br />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 endorsement(s).
<br />PRODUCER Eddie QUIIIareS Jr.
<br />CONTACT
<br />NAME: Eddie QUlllares
<br />PHONE 714.617.7150. FAX
<br />LAIC.No: 714.617.7158
<br />State Farm Agency
<br />E`kfA1L
<br />ADDRESS: eddie eddie insurance.com
<br />415 N. Broadway
<br />r Santa Ana, CA 92701
<br />INSURERS AFFORDING COVERAGE
<br />NAIC //
<br />INSURER A: State Farm General Insurance Company
<br />25151
<br />INSURED DOWNTOWN INC
<br />INSURER B: State Farm Fire and Casualty Company
<br />25143
<br />INSURER C:
<br />204 E 4TH STREET STE T
<br />INSURER D:
<br />SANTA ANA CA 92701
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 75-0450 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 TERMS,
<br />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 />SUBR
<br />POLICY NUMBER
<br />MM/�DIMYY
<br />MMI�O/YYYY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE I-K] OCCUR
<br />El
<br />92-CE-0933.0
<br />06/05/2018
<br />06/05/2019
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAM AGES(RE TE
<br />PREMISES Ea occurrence)
<br />$ 300,000
<br />MED EXP (Any one person)
<br />$ 5,000
<br />PERSONAL B ADV INJURY
<br />$ 1,000,000
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY PRO- LOC
<br />PRODUCTS-COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />ALL OWNED X SCHEDULED
<br />AUTOS AUTOS
<br />HAGE
<br />HIREDAUTOS j�' NON-
<br />AUTOS
<br />�
<br />F
<br />621 5237-F28-75
<br />12/28/2018
<br />O6/28/2019
<br />Ea accidenINEDt) SINGLE LIMIT
<br />$
<br />BODILY INJURY (Per person)
<br />$ 1,000,000
<br />x
<br />BODILY INJURY (Per accident)
<br />$ 1,000,000
<br />cciOWNED PROPERTY DAMHIREDAUTOS
<br />Peradent
<br />$ 1,000,000
<br />(t
<br />X
<br />UMBRELLA LIAR
<br />EXCESS LIAB
<br />OCCUR
<br />CLAIMS -MADE
<br />Y
<br />Y
<br />92-CE-Q781-7
<br />06/05/2018
<br />06/05/2019
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />rd
<br />AGGREGATE
<br />$ 2,000,000
<br />DED I x I RETENTION$ 10,000
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILIW YIN
<br />ANY PROPRIETORIPARTNEWEXECUTIVE
<br />OFFICE/MEMBER EXCLUDED? Y�
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS bel,
<br />N/A
<br />❑Y
<br />92-CE-R552-3
<br />06/05/2018
<br />06/05/2019
<br />WC STATU- X OTH-
<br />1,000,000
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE- EA EMPLOYE
<br />$ 1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />FIDELITYBOND
<br />�I
<br />Y1
<br />92-WV-60445-F
<br />10/03/2018
<br />10/03/2019
<br />BOND -AMOUNT $ 500,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Aftach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />City of Santa Ana its officers, agents, employees and volunteers are named as additional insured.
<br />Additional Insured endorsement issued for cerlifcate holder with Wavier of Subrogation and non-contributory
<br />CITY OF SANTA ANA
<br />20 CIVIC CENTER PLAZA SANTA ANA, CA 92702
<br />ATTENTION RISK MANAGEMENT
<br />BRIZA MORALES
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />©1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012
<br />
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