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IJE I� n� CERTIFICATE OF LIABILITY INSURANCE <br />°o41(27/2° e 1 <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($), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate, holder is an ADDITIONAL INSURED, the poliay(len) must be endorsed. If SUBROGATION IS WAIVED, subject to the <br />terms and conditions of the policy, certain policies may require an andoreomont. A statement on this certificate does not confer fights to the <br />cadlficale holder In Ilau of such endsreement6 . <br />PRODUCER Sarlah Devereaux•88rrlento$, Agent <br />1202 W t at St <br />s tform Santa Ana, CA 92703 <br />dtlTAg SpRIAtl DEVE, —�T <br />"Ha eW) �1q Td)1 7 R4 I,iANNLZL4 3�13A92 <br />sari devamev�itlj Pgla wform.nnm <br />NaaRafllaI AFPORCIMb COUaRAba NAMff <br />NaURER Ipta aim Fire and CervUalllY.QM8l)Y p_40_; <br />INSURED MENTE INC. <br />INSUM : <br />INSURER C: <br />8843 E VIA FRESCO <br />INIUKA b: <br />ANAHEIM, CA 92807 <br />INSURBL E: <br />INSURERF• <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />'rfIIS IS TO OEF'KITFY TTHAT THE POUCIFS OF INSURANCE USTED BELOW HAVE BEEN ISSUE) TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REOUIREMENT. 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 ANDCONDIVONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE SEEN REDUCED DY PAID CLAIMS, <br />INSR <br />TYPE OF INSURANCE <br />PYl1EY NUMaER <br />YM <br />�. UMIB <br />GENERAL UABIUrY <br />Y <br />L <br />02•EK48254 <br />OSAS12010 <br />OSMWM20 <br />EACH OCCURRENCE <br />1 11000,000 <br />COMMERCIAL GENERAL UADIUTY <br />CWMS•MAt1E � CIGGUR <br />$ <br />NEb E%P <br />5.000 <br />PERSOMM&ADY INJURY <br />a <br />GENERALAGGREGATE <br />a 2.000.000 <br />P °U5TS-CGMPN_WAGe <br />.S 2000,000 <br />beN'LAGGARGATE LIMIT APPUSS PER <br />s <br />TOLD P D. lUG <br />AUTOMMLE <br />DAGIUTV <br />EDGILY INJURY(PM P.—) <br />S <br />ANYAUTO <br />'wrasNED SCHEEAUTOa UD <br />FD <br />HIREDAUTOS AUTOS <br />BODILYINJURY (P«wddW) <br />5 <br />S <br />UMBRA. MAD <br />OCCUR <br />EACH OCCURRENCE <br />S <br />AGDREGATE <br />e <br />mmn UAS <br />CLAIA4aMhQE <br />COMPENSATION <br />WORMERS COMPEENSATION <br />ANY EMP FUSTO wwMry <br />ARYPROPRW'TORTARTNEWEXECVfNE YIN <br />E%CLUOEDT ®Nip <br />H' <br />MIT <br />E.L. EACH AGCIDEM <br />S <br />E.L DISEASE. FA EMPLOYE <br />S <br />I�rntwandgttog In NR <br />l�YrPBP jN <br />Pd <br />6. EASE -POLICY OMIT <br />Dw..wB: 2.000 <br />DESERRITONOPOPERATION61 LOGAflONEI VRMElE9 ((gIUNhAGORDTO1,MdlOwlelRMM1NW SMedulo.Hmde spM» M regnbed) <br />REVIEWED yAPPROVED <br />By RISk ANA{IEMIEW DiVISION <br />UpL 19 2019 <br />THE CITY OF SANTA ANA SAM#THA M. LAMBERT SHOULD ANY OF THE ABOVE DESCRIBED POLICIE$ BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 CIVIC CENTER PLAZA ACCORDANCE WITH THE POLICY PROVISIONS. <br />SANTA ANA, CA 92701 <br />' AYIMORUEO REPRESENTATIVE <br />1IH 1O ACORO O )RATIO if rll3hts DrVed. <br />ACORD 26 12010105) The ACORD name and logo are registorad marks of ACORD 100T 182849,8 01-23.2013 <br />