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AGCyN2Cl CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIOOIYYYY)
<br />DOCUMENT WITH RESPECTTO WHICH THIS
<br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
<br />08!11/2018
<br />THIS CERTIFICATE ISIS 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
<br />BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),
<br />AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
<br />IMPORTANT: If the certiflcate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
<br />PRODUCER
<br />CO TAC
<br />Colony West Financ161 Insurance Services
<br />NAME:
<br />gNON o (7q 542-4870
<br />License #OC420.20
<br />Ext (714 Sq2-A871
<br />AIc. No: )
<br />nD Re"I certlflcatesQcolony-West.com
<br />201 East Sandpointe Or #360
<br />INSURER 9 AFFORDING COVERAGE NAIC p
<br />Santa Ana CA
<br />INSURERA; Sentinel insurance Co, LTD 11000
<br />92707
<br />INSURED
<br />INsuaER s: PROPERTY &CASUALTY INS CO. OF HARTFORD 34690
<br />Sws2, Inc Dba the Ryte
<br />N9DRER C:
<br />4699 Monteflno Or
<br />INSURER D ;
<br />INSURER E:
<br />Cypress CA 90630
<br />NSURER F:
<br />COVERAGES m. sn.
<br />ttOVI5JUN NUMIGER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED
<br />NAMEDABOVE FOR THE POLICY PERIOD
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER
<br />DOCUMENT WITH RESPECTTO WHICH THIS
<br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
<br />HEREIN IS SUBJECTTO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY
<br />HAVE BEEN REDUCED BY PAID CLAIMS.
<br />LTR
<br />TYPE OF INSURANCE
<br />.X
<br />D
<br />POLICY NUMBER
<br />MMIdOIYYY
<br />MM OOIYEVYY
<br />LIMITS
<br />COMMERCIAL GENERAL LIABILITY
<br />RRENCE $ 1,000,000
<br />CLAIMS -MADE OCCUR
<br />DA
<br />Eaoccur nee S 1,000,000
<br />ny one cream $ 10,000
<br />A
<br />Y
<br />)258AUU2017
<br />09/05/2018
<br />09/05/20191,OOD,000
<br />&ADVINJURY $
<br />nGG
<br />GEML AGGREGATE LIMITAPPLIES PER:
<br />X PGucV PRG-
<br />JECT LOC
<br />GGREGATE $ 2,000,000
<br />-COMPIOPAGG 5 2,000,000
<br />OTHER
<br />LIABILITY
<br />SINGLE LIMIT a
<br />Q
<br />Ea cciden[
<br />BODILY INJURY (Per person) S
<br />SCHEDULED
<br />NLY AUTOS
<br />72SBALJU2017
<br />09/05/2018
<br />09/05/2019
<br />BODILY INJURY (Par eocldpm) $
<br />NON -OWNED
<br />ONLY X AUTOS ONLY
<br />E
<br />LUMDRELL�ALIAB
<br />Pee cid nt $
<br />Hired & Non -Owned s 7,000,000
<br />LALIAB
<br />X
<br />OCCUR5
<br />CLAIMS.MAOE
<br />72SBAU112017
<br />09/05/2018
<br />EACH OCCURRENCE
<br />5,000,000LIAB
<br />D9/05/201g
<br />AGGREGATE $ 5,000,000
<br />RETEMION S 10,000
<br />WORKERS COMPENSATION
<br />AND EMPLOYERVLIABILITY YIN
<br />a
<br />X STATUTE CRH
<br />B
<br />ANY PROPRIETOR/PARTNEWEXECUTIVE
<br />OFFICEWMEMBER EXCLUDED? ❑
<br />N/A
<br />72WECLR1801
<br />09/05/2018
<br />09/05/2019
<br />_
<br />E.L. EACH ACCIDENT g 1,000,000
<br />(Mandatory In NH)
<br />Ifyes,desadbeonder
<br />E.L. DISEASE "EA EMPLOYEE S 1000,000
<br />DESCRIPTION OF OPERATIONS below
<br />El_OISEASE-POLICY LIMIT S-1.,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES IACDRO 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />30 day notice of Carl except In the event of nonpayment.
<br />The City of Santa Ana, Its officers, employees , agents, and representatives are Included as additional insured per written contract or written agreement with
<br />respects to General liability policy per attached ondorsement form #S$ 00 08 04
<br />/05.
<br />"4✓"""ll 4it✓I✓�...at
<br />r
<br />r FOTIGIr aTC LI(tr nvo
<br />City of Santa Ana Finance Is Management Servs
<br />20 Civic Center Plaza, M-16
<br />PO Box 198
<br />Santa Ana, CA 92702
<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 />©1988.2015 ACORD CORPORATION. All rights roserved
<br />1,Pw ,wRu name ana logo are registered marks of ACORD
<br />
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