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APOSASS-76 CARC <br />,a►cc�►�2v CERTIFICATE OF LIABILITY INSURANCE <br />DAT <br />CERTIFICATE <br />__ 311312019 <br />THIS CERTIFICATE IS ISSUED ASA 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 pollcy(les) 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 andorsement(s). _ <br />PRODUCER C��CT Amy M MCBFIC@ <br />Services (ACG) <br />124 <br />307.1245 <br />INSURED <br />INSURERS: <br />Apostolic Assembly of the Faith In Christ Jesus ribs iglesia <br />INSURER <br />Apostolica Sion <br />12942 Old Foothill Blvd <br />INSURER D <br />Santa Ana, CA 92705 <br />INSURER E <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: <br />REVISION NUMBER: <br />THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW <br />HAVE BEEN ISSUEDTOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTUVITH STANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENTWITH RESPECTTOWHICH 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 />ADDL <br />TYPE OF NSURANCE D <br />SL'BR <br />wvD <br />POLICY NUMBER <br />-POLICYEFF POLICY EXP <br />MMlD Y MMxSrvSYY1' LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE. 1'000'000 <br />GLAIMS-MADr X OCCUR X <br />X <br />04M5AO498911 <br />9/1/2018 9/1/2099 PREA SES°Ea ooE'irJence $ 1,000,000 <br />10'00 <br />MEDEXI(An was e.s ) g <br />9,000,000 <br />PERSONAL &ADV INXRv A <br />5'000'000 <br />GEN'L AGGREGATE LPI�MO()IT APPLIES PER <br />GEN9PRALAGGREGATE $ <br />X POLICY �P!FG1' LOC <br />PRODUCTS-COMP/OPAGG 8 ,000,00 <br />OTHER'. <br />^ <br />" <br />COMEINEO SINGLE LIMIT <br />AUTOMOBILE LIABILITY <br />Ea ccldent $ _ <br />PNYAUTC <br />5OIPILVNJURY(POPRNpr�ereon) $ <br />AUT(7S ONLY AUTGSULED <br />BODILY INJURY or acGaent S <br />A� p �Ep <br />AUONLY <br />PROPERTY �MA(3E <br />Per adent $ <br />AUP�%ONLV <br />UMBRELLA LIAR <br />OCCUR <br />BCH OGGIRREN(� $ <br />EXCESS LIAS <br />CLAIMS -MAGE <br />AGGREGATE <br />DEO RETLNI ONI <br />�.. <br />WORKERSCOMPENSATION <br />1'' 0TH- <br />I TATUTE ER <br />AND EMPLOYERS'LIABILITY <br />ANY PROPRIETORIPARTNERIEX-TCU1'I VE �YINI <br />EL. TACH ACCIDENT W <br />OFPICERIM MBER EXCL.IIDm? a WA <br />(MantlaCoryPn NH) <br />EL. DISEASE-EAEMPLOYEE @ <br />if yes, f,ceodbs Udder <br />trew <br />EL�IA-PS <br />. OLCY LIM7DESCRIP�ATkNS <br />DESCR PTION OF OPERATIONS I LOCATI DNS f VEHICLES (ACORD 101 Additional Remarka Sc hetlule, may do attached if more space I® required) <br />RE: Use of parking lot at 308 N. Main Street, Santa Ana, CA. Certificate holder is named as additional insured. An insured may waive the right to recover, in <br />writing, before an occurrence takes place. <br />CERTIFICATE HOLDER <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Cit of Santa Ana, Its officers, officials, <br />Y <br />ACCORDANCE WITH THE POLICY PROVISIONS, <br />employees and agents <br />20 Civic Center Piaia (M-25) <br />PO BOX 1988 <br />AUTHORIZED REPRESENTATIVE /� h7( <br />V <br />Santa Ana, CA 92702 <br />,— �,✓t`c`,-a:J h ®(/ <br />Zc <br />i <br />ACORD 25 (2016103) <br />O 1958-2015 ACORD CORPORATION All rights reserved. <br />The ACORD name and logo are <br />registered marks of ACORD / J <br />