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CERTIFICATE OF LIABILITY INSURANCE DATE(MMOD"") THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE H 11 512019 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COLDER. THIS OVERAGE 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(ies) 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 auch endorsements N. PRODUCER CD ACT RITA M PRICE INSURANCE AGENCY INC. N � PNON-- - --- — E 909 337.2518 PO Box in.MUL - we x P (9091336.6989 Ao RE r, rlc INSURfarmersaaent.com ____ Lake Arrowhead, CA 92352 ERISI AFFORDING COVERAGE 0544472 -- — xAlc e INSURED RACE CENTRAL LLC JUDYIKENBERRY 229 S. OLIVE AVE COVERAnFa I_NBURER D : - INSURERE: .a,arocn• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW REVISION NUMBER: HAVE BEEN ISSUED TO THE INSURED NAMED ASOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY INSR - -_ _ 'AD —.-- PAID CLAIMS. R TYPE OF INSURANCE POLICY NUMBER N�pCY EFF X DOMNERCIAL GENERAL LIABILITY __ _ _ _ IPaOLICDY E%P LNJITS __- CLA1A13-MADE X OCCUR 'EACH OCCURRENCE ,S 11000,000 G O PREMISEl S 100,000 A —� ---..— X HSD10015218029 112712019 MEOEXP(Any one pe ) $ 5000 1127/2020 GENL AGGREGATE LIMIT APPLIES PER: PERSONAL & ADV INJURY f 1.000OQQ POLICY _ PRO- LOC JECT— GENERALAGGREGATE S - 2,000,000 OTHER. PRODUCTS-COMPIOPAGG S 1000000 AUTOMOBILE LIABILITY $ LI I MY AUTO fEe aBlN aF-0atgINGLE f OSCHEDULED BODILY INJURY(Parpenom S AUTOS ONLY AUTOS HIREDIRED —� NM-OWNED'BODILY —'--_ -- '-- INJURY (PeraxMsnll S __ AUTOS ONLY AUTOS ONLY PROPERTY D— gMpOE '--r- If f UMBRELLA UMBRELLA LUB OCCUR f EXCESS use ._ CLAIMS -MADE EACH OCCURRENCE $ DED RETENTIONS AGGREGATE S -- -- WORKERSCOMPENSATION S AND EMPLOYERS' LIABILFTY YIN PER OT I STATUTE ER ANY PROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? NIA 'ESL EACH ACCIDENT BEACH ACCIDENT q (Mmtlenry In NN) Oyee, tlIFI uMer DESCRIPTION OF OPERATIONg Oelaw E.L. DISEASE - EA EMPLOYE S E.L. pISEASE- POLICY LIMB I E I I REVIE DESCRIPTION OFOPERATIONS ILOCATIONSIVEHICLEa(AC00.0 1e1, Atltlltlonal RemarNa SchetlWe, may WaNecMdXmonepeu len ( �t�S 1ANAYEMEW CertiBrale holder Is listed as aasiNonal insured: ' n I)iVISION The City of Santa Ana, Risk Management, Its of icers, employees, agents, volunteers and representatives as atilt nal insured. CedIFORt011 12 CertiRcate of Inaunnca shall pmvitle lhldy (70) dry prior wmen notice of oanmllation 2019 SAM NTHA M, LAMBERT CERTIFICATE HOLDER City of Santa Ana, Risk Management 20 Civic Plaza, 4th Floor Santa Ana CA 92702 ecnlxn �c nn�mnm 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 REPaBBENTATIVE 1090 are mglsrerea marks of ACORD All Monte