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l SURET-1 <br />OP 113* <br />CERTIFICATE OF LIABILITY INSURANCE <br />D1112212019ATE Y) <br />11/22/2019 <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 policy(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on <br />this certificate does not confer rights to the certificate holder In lieu of such endomemen s . <br />PRODUCER 961-680-9600 <br />Daisy Trudeau Ins. Services <br />CA Lic. #01-52222 <br />cT Diana Castanon <br />PHONE 951.680-9600 FAX 888-Y61-9664 <br />INC. No, Ertl: (AIC, No): <br />dFan—a@daisytruassuine.com <br />5016 Canyon Crest Dr. Ste. 207 <br />Riverside, CA 92607 <br />Daisy Trudeau <br />11 SI AFF_QMlblg COVERAGE MAID <br />INSURER A:AnIGUARD Insurance Co. <br />42390 <br />INSURED Sureteck Industrial <br />& Commercial Services, Inc <br />860 E Cottonwood St <br />INSURER G: Ohio Security Insurance Co <br />24082 <br />wSuRERC,Oak River Insurance Company <br />34630 <br />Ontario, CA 91761 <br />INSURER D: <br />INSURER E : <br />INSURER F: <br />C ERAGES CERTIFICATE NUMBER: REVISIONNUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <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 ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUER WVO <br />POLICY NUMBER <br />POLICY EFF-1POUCY EXPMMMUMM <br />„rs <br />B <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE [A] OCCUR <br />X <br />BLS56936915 <br />03101/2019 03101/2020 <br />EACH OCCURRENCE <br />11000,000 <br />GETORENTED <br />S 500,000 <br />M P An WS <br />15,000 <br />PERSONAL ADVINJURY <br />1,000,000 <br />GENL <br />AGGREGATE pLIRMpIT. APPLIES PER: <br />POLICY ❑X JEGT LOC <br />OTHER: <br />GENERAL AGGREGATE <br />2,000,000 <br />PRODUCTS -COMPIOP AGG <br />2,000,000 <br />S <br />A <br />AUTOMOBEELmmm <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY X ANUpT�OByy��p <br />X AUTOS ONLY X A8TOJV61V <br />UAU014314 <br />06119/2019 0611912020 <br />COMBINED SINGLE UNITY <br />S 1,000,000 <br />BODILY INJURY Pm <br />BODILY INJURY PW=ddW <br />$ <br />�PS�ER�1', MAGE <br />Ii <br />UMBRELLA LU1B <br />EXCESSLJAe <br />OCCUR <br />CLAIMS.MADE <br />EACH OCCURRENCE <br />AGGREGATE <br />DED I I RETENTION S <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABAITY <br />ANYRRRIETORTTIIEIECUTVE YIN <br />8QFlEMEEMMD <br />If1es,tle ivu <br />DESCRIPTION OF OPERATIONS tl . <br />NIACWyQE <br />SUWC036591 <br />11/2212019 <br />11/2020 <br />OTH- <br />X PERTUTE <br />STA <br />E.L. HA ACCIDENT <br />1,000,000 <br />E.L DISEASE - EA EMPLOY <br />S 1,000,000 <br />E.L. DISEASE -POLICY UMIT <br />S 1,000,000 <br />64 SCRI ERA IIDCATq"I/ VEHICLES CORD 10 onal Ro,naM$SeC P �WeME tlnaoae aqu N,spulned) <br />of alnia°FLna,Toi cars, agents employees, l5,oiunteers areNincilt ��So <br />additional insured as respects to General Liability per form CG8810 0413, <br />where required by written contract Primary wording/ Non-contributory <br />.applies perform CG8810 0413. <br />CITYSAI <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana CORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management DivisionREVIEWED & APPRGVLt <br />20 Civic Center Plaza By RI MANAGEMENT Div! <br />4th floor pRvm•REPRESENTATNE <br />Santa Ana, CA 92702 I 12 2019 <br />ACORD 25 (2016/03) /\Jl Z © 1988-2015 ACORD CORPORATION. All rights reserved. <br />ThS �IN fM MdfI"firr"istered marks of ACORD <br />