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CITYG-1 OP ID. C <br />' CERTIFICATE OF LIABILITY INSURANCE oA'I 1 <br />lmmrorvvyrYl <br />_ _ 0S2912019 <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(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the pnllcy(ies) must bo endorsed. if SUBROGATION IS WAIVED, subject to <br />the terns and conditions of the policy, Certain policies may require an endorsement. A statement on this certificate do" not confor rights to tite <br />a Insurance Agency, Inc. -�yg (pq� <br />#OC42488 y Ip9169615000 W_ttA+9'Nh4.91t <br />zol Avenue, Suite 110 !o� fj4l]b!oD Dg^ifnI istnanra tCa com <br />a, CA 95628 ,._ .,,.v. <br />S Insurance Agency, Inc INS DING COVERAGE <br />INSURER A: Samna[ Inopr mce Company Ltd <br />600 Coolidge Drive, Suite 160 <br />Folsom, CA 96030 <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, 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 ALI. THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />CLAMS -MADE 0X1 OCCUR ' X I X 157SSAAZ1255 1071161201910711612020 <br />L AGGREGATE LIMIT APPLIES PER: <br />POLICY N X O CJ LOG <br />AUTOMOBILE LIABIUW <br />vMrHr v;r'.w.c ww $ <br />A ANYAUIO <br />X <br />57SBAAZ1255 <br />0711512019 0711612020 <br />E00ILV INJURY (Par pnrapn)'$ <br />. ALLOWNED "6CHEDULEO <br />AUTOS AUTOS <br />""" <br />a04NLY INJURY(Per'"11:t) $ <br />I <br />X-. AUTOS ED <br />T+p iY $ <br />MRF.DAAJrOS <br />...,.., _._ <br />.L4aRt ....... .....: ._ <br />X'. UmBRELtA UAB X OCCUR <br />EAGHOCCURRENCC 5 <br />A excess UAac IMaMAD <br />575SAAZ1255 <br />4711512019 47M512020 <br />,AGGREGA E $ <br />AND EMPLOYERS LIABILRY YIN ;. <br />IANY PnwnRiver olTrPARrnERrrlxE,r;urme X 57WECEU6620 10101/2018 10f0112019 EI LAL.HnwIakNT s <br />okrle ErzrMEMUER rxcl.urxenY {NIA' <br />A Eimandamry In NNi I � ��� EL CI9EABE EA EMPLOYE $ <br />omtaxions <br />OP OPERATIONS! LOCATIONSI VEHICLES CACeRO TUT, Atltlitionai Ramarka 9chaduN,may bo attached {t mom apace it regain <br />al Insured: The City of Santa Ana, its officers, agents, and <br />a in regards to the General Liability as per the attached. Primary <br />atributory per attached Form SS 00 08 04 05. (30) Days Notice of <br />Lion as per attached Form SS 12 23 06 11, <br />City of Santa Ana <br />Risk Management Div <br />20 Civic Center Plaza, <br />Santa Ana, CA 92702 <br />Occur <br />032019 ULD ANY OF THE ABOVE EXPIRAnON DESCRIBED POLICIES DATE THEREOF, NOTICEWILL BE <br />ELLED BEFORE <br />THEDELIVERED IN <br />ACCORDANCE MTN THE POLICY PROVISIONS. <br />MLAMHER'AUTHORDED REPRESENTATRIE <br />©1988.2014 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2014101) The ACORD name and Toga are registered marks of ACORD <br />