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A��!zp� CERTIFICATE OF LIABILITY INSURANCE <br />D6/26/zo e ) <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 <br />the 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 <br />Amorelli, Rosemann & Associates Insurance Services <br />3333E Concours St <br />Building 9-200 <br />Ontario CA 91764 <br />NANEACT Lizette Barges <br />PHONE (909)987-7600 aC No:(909)987-7656 <br />-MAIL lizetteb@arainsurance.com <br />ADDRESS: <br />INSUREI AFFORDING COVERAGE <br />NAIC # <br />INSURERA:State Coal Insurance Fund <br />35076 <br />INSURED <br />Mdg Associates, Inc. <br />10722 Arrow Route Ste 822 <br />Rancho Cucamonga CA 91730 <br />INSURER B: <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER:18/19 WC 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 />rypE OF <br />ADDL <br />SUER <br />POLICY NUMBER <br />POLICYEFF <br />MM DDIYVYV <br />POLICY E%P <br />M DD <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE El OCCUR <br />EACH OCCURRENCE <br />$ <br />DAMAGE TO RENTED <br />PREMISES Es accurren e <br />$ <br />MED EXP (Any one person) <br />$ <br />PERSONAL &ADV INJURY <br />$ <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ <br />GEN'L <br />POLICY PRO- ECT ❑ JOB <br />PRODUCTS - COMPIOP AGG <br />$ <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ <br />BODI LV INJURY (Per person) <br />$ <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY Per accident <br />( ) <br />$ <br />HIRED AUTOS NON -OWNED <br />AUTOS <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />is <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNERIEXECUTIVE ❑NIA <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe under <br />1980750-18 <br />7/1/2018 <br />7/1/2019' <br />X PER OTH- <br />STATUTE ER <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 />$ 11000,000 <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (ACORD IOf, Additional Remarks Schedule, may be attached if more space is required) <br />PROOF OF INSURANCE FOR CITY OF SANTA ANA COMMUNITY DEVELOPMENT AGENCY. <br />4� <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />CITY OF SANTA ANA <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ATTN: TERRI EGGERS, SENIOR MGMT ANALYST <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />COMMUNITY DEVELOPMENT AGENCY <br />AUTHORIZED REPRESENTATIVE <br />20 CIVIC CENTER PLAZA <br />SANA ANA, CA 92701� <br />Lizette Barges/JULIO YJ� <br />©1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014/01) <br />INS025 1961401) <br />The ACORD name and logo are registered marks of ACORD <br />