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CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DDNYYY) <br />10/23/2019 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE <br />AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE <br />ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, <br />subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does <br />not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT NAME: <br />PAYCHEX INSURANCE AGENCY INC <br />PHONE (877)266-6850 <br />INC, No, Ect): <br />FAX (585)389-7894 <br />(AIC, No): <br />76210705 <br />150 SAWGRASS DRIVE <br />ROCHESTER NY 14620 <br />E-MAIL ADDRESS: <br />INSURER(S) AFFORDING COVERAGE NAICX <br />INSURER A: Hartford Fire and Its P&C Affiliates <br />00914 <br />INSURED <br />INSURER B : <br />NILA INC. <br />INSURER C : <br />723 W WOODBURY RD <br />INSURER D: <br />ALTADENA CA 91001-5310 <br />INSURER E <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <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 <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSP <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXP <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />CLAIMS-MADE❑OCCUR <br />DAMAGE TT RENTED <br />PREMISES (Ea occurrentel <br />MED EXP (Any one person) <br />PERSONAL A AOV INJURY <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />POLICY 0 PRO - ❑ LOC <br />JEC <br />PRODUCTS -COMP/OPAGG <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Qen <br />ANY AUTO <br />BODILY INJURY (Per person) <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accitlen0 <br />HIRED NON-OMED <br />PROPERTY DAMAGE <br />AUTOS AUTOS <br />(Peraccitlent) <br />UMBRELLA LUV1 <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAR <br />CLAIMS - <br />MADE <br />AGGREGATE <br />E <br />I RETENTION$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />PER <br />TAT <br />X <br />OTk4 <br />EL EACH ACCIDENT <br />$1,000.000 <br />ANY YIN <br />A <br />PROPRIETOWPARTNEREXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />NIA <br />76 WEG DS8068 <br />01/16/L011/1612020 <br />E.1- DISEASE -EA EMPLOYEE <br />$1,000,000 <br />(Mandatory in NMI <br />R yes. describe urKer <br />EL DISEASE -POLICY LIMIT <br />$1,000.000 <br />DESCRIPTION OF OPERATIONS <br />DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schetlule, may be attached R more apace is required) <br />Those usual to the Insured's Operations. <br />CERTIFICATE HOLDER CANCELLATION <br />City Of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />Parks, Recreation and Community Service <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br />20 CIVIC Center Plaza <br />IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92701 <br />ACORD 25 (2016/03) <br />1 qh <br />RXFTT1 .:. -n TMIT LI-:.,.1,1,,. -�,,: <br />The ACORD name and logo are registered marks of ACORD <br />ON I5 019 � <br />FRANCINE R. VILLAREAL <br />