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CERTIFICATE OF LIABILITY INSURANCE °A 7101/2 19 o7ro1/za1 s 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 INSURERS►, AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder Is an ADDITIONAL INSURED, the policy{ies) must have A001TiONAL 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 NAµEAOT David I Reyes _ St3teFarm David I Reyes PRONE 714-527-5103 IWc, ue): 714-527-4365 .(AK: ttu JexLl 2840 W Lincoln Avenue reyes.b88j@slatefarm.com Anahelm, CA 92801 INSURER AFFORDING COVERAGE NA1C # ,,,,,,. a. State Farm Mulual Aulomoblie Insurance Company 25178 INSURED INSURER B FELIPE SOSA DBA SUSY PARTY RENTAL INC. INsuRER c 1517 S SYCAMORE ST INSURER O: SANTA ANA CA, 92707 INSURER H: Y•nnVICIPAT=LIIIRR000. RRVISInN WEIMRFRE 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. LIMIT$ SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. irJSR TYPE OF INSURANCE ADDL 9t --- - POLICY NUMBER P CY EFF POLICYDE P COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS -MADE OCCUR T7A�ENT{:i] EMiLES_(c f MED EXP A one rwn $ ~ PERSONAL S AOV INJURY f GEN'LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ PRODUCTS -COMPIOPAGG $ POLICY ❑ jEF LOC $ OTHER AUTOMOBILE LIABIUTY Y G eBI�r051 LELI 3 1,000,000 BODILY INJURY (Per person) $ ANY AUTO 553 0052-C20-75A 06/26/2019 12/25/2019 BODILY INJURY (Per aoddenl) S A OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY I 635 6634-D19-75 04/19/2019 •10119/2019 PROPER AGE $ $ ( COLL 1000 UMBRELLA LIAB OCCUR EACH OCCURRENCE f AGGREGATE S EXCESS LIAR CLAIMS -MADE DEO RETENTION S S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERTIEMBER EXCLUDED? (Mmdatory In NH) N r A H- TOTE $ E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ If yyees, de.5aibe "order D!_5CR1, 14N OF OPERATIONS below DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarlca Schedule, may be attached It more apace Is required) 1999ISUZU NPR BOX VIN:JALB4B149X7015770 n,�j7 2005ISUZUNQRBOX VIN:JALE6J16567903323 /�},/ !!I �6A(��8" V y ` CERTIFICATE HOLDER IS THE ADDITIONAL INSURED R�vvl rRRTIRr'ATFi4nI rlt=rd CANCELLATION mu'" SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE D RED IN CITY OF SANTA ANA RISK MANAGEMENT ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA AUTHORD:EDRF.PR TiVf: SANTA ANA, CA 92701 All rirrht rpcarvnrl ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD 1001486 13284012 0316-2016 1�