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A o>Ro CERTIFICATE OF LIABILITY INSURANCE
<br />ovo 120 9
<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 />State Farm Agency
<br />415 N. Broadway
<br />,���., Santa Ana, CA 92701
<br />NAMEACT Eddie QUIIIareS
<br />PallHONE . 714.617.7150. aIc Nn :714.617.7158
<br />EMAIL
<br />ADDRESS: eddleCcDeddletTinsurance.com
<br />INSURER(St AFFORDING COVERAGE NAIC#
<br />INSURERA: State Farm General Insurance Company 25151
<br />INSURED DOWNTOWN INC
<br />204 E 4TH STREET STE T
<br />SANTA ANA CA 92701
<br />INSURER B: State Farm Fire and Casualty Company 25143
<br />INSURER C:
<br />INSURER D:
<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 />INNER
<br />LTR
<br />I TYPE OF INSURANCE
<br />ADDLSUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYYY
<br />POLICY EXP
<br />MMIDDIYYYI'
<br />LIMITS
<br />A
<br />GENERAL LIABILITY��
<br />92-CE-Q933-0�
<br />06/05/2018
<br />06/05/2019
<br />EACH OCCURRENCE $ 1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE 1XI OCCUR
<br />DAMAG RE ED
<br />PREMISES Ea occurrence $ 300,000
<br />MED EXP (Any one person) $ 5,000
<br />PERSONAL &ADV INJURY $ 1,000,000
<br />GENERAL AGGREGATE $ 2,000,000
<br />GEN'LAGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGG $ 2,000,000
<br />POLICY PRO
<br />IET F LOC
<br />$
<br />A
<br />AUTOMOBILE LIABILITY
<br />6215237-F28-75
<br />12/26/2018
<br />06/2812019EaeBINED
<br />SINGLE LIMIT $
<br />BODILY INJURY (Per person) $ 1,000,000
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS y` AUTOS
<br />BODILY INJURY(Pm.eNd.m) $ 1,000,000
<br />X HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />PROPERTY DAMAGE
<br />Per accident $ 1,000,000
<br />A
<br />X UMBRELLA LIAR
<br />X
<br />OCCUR
<br />❑Y
<br />❑Y
<br />92 -CE -Q781-7
<br />06/05/2018
<br />06/0512019
<br />EACH OCCURRENCE $ 1,000,000
<br />AGGREGATE $ 2,000,000
<br />EXCESS DAB
<br />CLAIMS -MADE
<br />DED I X RETENTION$ 10,000
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YIN
<br />ANY PROPRIETOR' PARTNEREXECUTIVE
<br />OFFICE/MEMBER EXCLUDED? YY
<br />N I A
<br />92 -CE -R552-3
<br />06/05/2018
<br />06/0512019
<br />WDC STATUS X OTH 1,000,000
<br />EL EACH ACCIDENT § 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000
<br />(Mandatory In NH)
<br />If yes, deecdbe antler
<br />E.L. DISEASE -POLICY LIMIT $ 1,000,000
<br />DESQEIET[QN OF OPERATIONS below
<br />A
<br />FIDELITY BOND
<br />FYI
<br />92 -WV -60445-F
<br />10103/2018
<br />10/03/2019
<br />BOND -AMOUNT $ 500,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach 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 certificate holder with Wavier of Subrogation and non-contributory
<br />ki ny
<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 />AUTHORIZED REPRESENTATIVE
<br />1oRR-2nln Annpn cnppnPATlnhI
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1OW486 132849.7 03-01-2012
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