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ACC �� CERTIFICATE OF LIABILITY INSURANCE DATEtMMlDD"Y" 06/26/2019 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 have ADDITIONAL INSURED provisions or 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 endorsements . PRODUCER StateFelfM TERRY BRADSHAW, AGENT LIC, #OB80831 17871 SANTIAGO BLVD., SUITE 207DOM VILLA PARK, CA 92861 coVASQUEZ 37-4120 A No): 714-637-4260 @TERRYBRRl7511AWORG SURER 9 AFFORDING COVERAGE NAIL S URERA:ate Farm General Insurance Company 25151 INSURED HENNESSEY & HENNESSEY, LLC, 17602 17TH STREET, SUITE 102-246 TUSTIN, CA 92780 INSURER B: State Farm Mutual Automobile Insurance Company 25178 tNSURER c; INSURER D : INSURER E: INSURER F: 0�eIV1CCA/_-CQ /`C0T101r`A TF RII IRMR9=0, RFVICInIu NIIMRFR- 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. IL SR TR TYPE OF INSURANCEW16 LTEIR POLICY NUMBER POLICY EFP POLICY eXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1.000,000 CLAIMS -MADE ® OCCUR M?SES Eaoocurmnce s 300,000 MED EXP (Any one arson) $ 6,000 A Y Y 92-CZ-W382-6 05/16/2019 05/16/2020 PERSONAL &ADV INJURY S 1,000,000 +j GENLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2.000,000 PRODUCTS-COMP/OPAGG s 2,000,000 POLICY ❑ PRO- LOC JECT I S OTHERS I! AUTOMOBILE LIABIIJTY Y Y CdMBINE0 SINGLE LI 1 S 1,000,000 BODILY INJURY (Per person) S B ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 471 7092-E19-75C 05/19/2019 11/19/2019 BODILY INJURY (Peracoldent) S PROPERTY DAMAGE 1pq Aqjgena $ a UMBRELLA U AB OCCUR EACH OCCURRENCE S 2,000,000 AGGREGATE _ S 2,000,000 A EXCESS LIAR CLAIMS -MADE N 92-CZ-W386-5 05/15/2019 05/15/2020 DED RETENTION III s WORKERSOTH- COMPENSATION AND EMPLOYER S' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y❑ OFFICERIMEMBER EXCLUDED? (MandatorylnNH) NIA PER T E.L.EACH ACCIDENT $ E-L.DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT $ If yes describe under DESCRIPTION OF OPERATIONS balm T^ DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, AddIllenal Remarks Schedule, maybe attaohed if more apace Is required) City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this policy pursuant to written contract, agreement, or memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and noncontributory Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation CERTIFICATE HOLI CITY OF SANTA AN Risk Management Div sign 20 CIVIC CENTER PLAZA SANTA ANA, CA 92702 U ❑Cj Rent DIVIslon N SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Terry Bradshaw, Agent Statefarm insurance License N01380831 WWI - Villa 17871 Santiago Blvd, Suite 207 Park, CA 92061.4117 ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 1001466 132849.12 03-1(1-2016