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IIIII n® CERTIFICATE OF LIABILITY INSURANCE 091'16i2o s I 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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPUK IAJ4I: It the Cel'titiCate holder !San ADDITIONAL INSURED, the policy(ies) must 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 endorsement(s). PRODUCER Eddie Quillares Jr. State Farm Agency NAME: EddieQuiliares Jr.PH _ 415 N. Broadway WC fie. EML.71-4,017 7154. iovc,.Ito 714-017.7150_ EMAIL Santa Ana, CA 92701 AoDREss eddleQeddleginsuranceCom_ INSURERS) AFFORDING COVERAGE I NAIL Y + i INSURER A: $foie Farm Fife and Casualty Company_ INSURED Santa Ana Chamber of Commerce INSURER B: Stale Farm General Insurance CDmpsny 1631 W. Sunflower Ave STE C35 INSURER c: Santa Ana, CA 92704 INSURER D __ _ ATTN: Marty Perterson INSURERS, INSURER F : COVERAGES CERTIFICATE NUMBER'9R-nAsn RFVISInM NIIMRFu• 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR T TYPEOFINSURANCE ADDL SUB POLICY NUMBER POLICY EFF MMiti POLICY EXP IMMIDDIYYYYILIMITS A GENERAL LIABILITY Y 92-CM-E499-2 03101/2019 03/01/2020 EACH OCCURRENCE E_ 3,000,000 DAMAGE TORENTEO- -- - MERCIAL GENERAL LIABILITY PREMISES(Ed pm,mence) S 300,000 1_7 CLAIMS -MADE OCCUR MEO EXP (Any one oerson) I E 10,000 PERSONAL 8 ADV INJURY $ 3.000,OD0 C _ GENERAL AGGREGATE E 6,000,000 GENI AGGREGATE LIMIT APPLIES PER: I PRODUCTS - COMPIOP AGO $ 6.000,000 POLICY I I PRP LOC $ B AUTOMOBILE LIABILITY _ 1 431 6546•COt•75 09/01/2019 09/01/2020 COMBINED SINGLE LIMIT (Enecridenl) $ ANY AUTO BODILY INJURY (Per person) 1,000 AO- SCHEDULED AUTOS ALTOSAUTOS BODILY INJURY (Perauieeny�'E S 1,000 _) HIRED AUTOS J( iAUTOSNON-OWNED AUTOS _ PROPERTY DAMAGE E 1.000 1P v,eprrp _ S I UMBRELLA LIAR _ OCCUR EACH OCCURRENCE E E%CES3 LIAR CLAIMS -MADE AGGREGATE S OED I I RETENTIONS WOBTATU- L OTH-- E A WORKERS COMPENSATION _ "aEMPLOYERS' LIABILITY YIN 92-GA-D121-9 02/0112019 02/01/2020 TORY_LBATS —Eft_ ANYPROPRIETOWPARTNEWEXECUTIVE I EL EACH ACCIDENT S 1,000,000 Y OFFlOEIMEMBER EXCLUDED,, Y❑ N/A _ - (MantletmyleNH) EI DISEASE -EA EMPLOYE S 1.0.00,000 EL DISEASE -POLICY LIMIT I _.— S 1,000,000 eye;de TION under APPROVED MCADNAGIE�JMENTDIVISION DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ANaph ACORD 101, Addlllenal Remarks Schedule, it mare epaco ie reeuired) By RISkANEL • �RA FFVILLAREALL City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92702 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 REPRESENTATIVE A'a&& W ACORD 25 (201 D/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012