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CE <br />TIFICATE OF LIABILITY INSURANCE DATE(MWDDNYYY) <br />THIS CERTIFICATE IS ISSUED AS <br />MAT <br />R OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HIS19 <br />CERTIFICATE DOES NOT AFFIRM <br />TIVEL <br />HOLDER10118 <br />OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY <br />BELOW. THIS CERTIFICATE OF I <br />REPRESENTATIVE <br />SURA <br />THE POLICIES <br />CE DOES NOT CONSTITUTE A. CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED <br />OR PRODUCE <br />, AND <br />HE CERTIFICATE HOLDER, <br />IMPORTANT, If the certificate helper <br />If SUBROGATION IS WAIVED, subj <br />Is an <br />01 tot <br />ADDITIONAL INSURED, the Policy(las) must have ADDITIONAL INSURED Provisions or be ondorsed. <br />a terms <br />this certificate does not confer ri <br />is to th <br />and conditions of the policy, certain policies may require an endorsement A statement on <br />certificate holder In Ileu of such endorsement s , <br />GO CT <br />NAM @._- Nice LLorin <br />PRODUCER <br />82Insurance Service <br />1426 Aviation Bivd S <br />, <br />ite 20424 <br />._ <br />bHOrvE-----..___.._____... <br />xn. )2$6.9400 rA� M1oJL��4.-j8$8^7660 <br />Redondo Beach, CA 9 <br />278 <br />-MAIL 99_ nice b2insurance.conn <br />License #; 0122551 <br />INSDREkt3jAFFOROW11 COVERAGE _. NAICN� <br />24082 - <br />Brightlife Designs <br />16291 Gothard St <br />Huntington Beach, <br />--...... <br />THIS IS E CERTIFY THATTHE. G ANY <br />INDICATED. NOTWITHSTANDING ANY <br />CERTIFICATE MAY O DITIONSSUED OFF <br />EXCLUSIONS AND CONDITIONS OF SU <br />L,M TYPE OF INSURANCE _ <br />S OF IN <br />ERTAI <br />PERTAI <br />H POLI <br />_ <br />_-.-••,+,.,�".. "�R�Rurvu REVISION NUMBER: 26 _. <br />URANCE LISTED BELOW HAVE BEEN ISSUEb TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />MENT, TERM OR CONDITION OFANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,. <br />iES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />_ ��f�)'OL OI YEFF` PO-L'(CY E)(P <br />POLOYNUMBE0. D Y IO Y LIMITS <br />Y BL355756204 0$l31/2019 ''. OB731/2020 EACHOCCURRENCE $ ��. OQQ(j <br />AATtEET(F <br />A <br />X COMMERCIAL GENERAL' LIABILITY <br />CLAIM&MADE OCCUR <br />Y <br />_._.l LhI <br />REl <br />E �RflEM ES E"e1" e $ 500 900 <br />..._ ...�_ _.._ <br />MCDEXP(Anyggaparqq) <br />GE N'LAGGRE <br />GEjG�A�TE LiMiTAPIP�LIE�S PER: <br />_ <br />PERSONPL aADV INJURY_ OOgg <br />aQ <br />X L..I JEC LOO <br />GENERAL AGGREGATE $ 2,_OOO, OQQ <br />�rPRCOVCTS.COMP/OPAGG <br />L J <br />OOLICY HER' <br />,S. _.T 2T(fQOA000_ <br />t1 AUTOMOBILE LIABILITY <br />ANYAUTO <br />Y <br />$ <br />Y BRAU048580 10/0912010 10/0912020 Ea INeo I Ir y <br />1 Qen1]�_ s !iyi�QO_x�Iq Q. <br />OVJNEO SCHEDULED <br />BODILYINJURY(Pa^pow) S <br />AU1HIRED ONLY NONOl <br />BOCLY INJURY (Per ac:rdenn S <br />AUTOSONLY AUTOSONLY <br />PROPeRiTDAMAdE <br />UMBRELLAUAB )(, OCCUR <br />IE%CESa LIAR � 11 <br />Y <br />Y i ESA58756204 06131/2019 00/31/2020 EACH Ig 2 000,900 <br />RRENGE 00,0 <br />_ CLNMSMA <br />OED RETENTION N <br />E <br />AGGREGATE _-___F• Z ODOOOO <br />l--d --- <br />WORKERSCDMPENSATION <br />"`�"' I $ <br />AND CMPLOYERS' LIABILITY Y/N`�[yjll <br />ANYPROPRIEfORIPARTNERIEXECUTIVE <br />ems® oOl �--- <br />---- --__ <br />OFFICEMMEMBEREXCL➢DED? <br />IMandelory in NH) <br />N/A <br />i� ; E.L EACH ACCIDENT <br />r-- <br />if e.deecIONOF r <br />01•escRiPnON OFOPERAfiONS <br />aL DISEASE -EA EMPLOYE 3 <br />EIL DISEASE, PODOY LIMIT $ <br />DESCRIPTIDNOFOPERATIONSi LOCATIONSIVE <br />Cityof Santa Ana, Its officers, om <br />ICLES (A <br />IGyee <br />ORD 101 Addabnal Ram�%a��g P bo&-�---hod ma------ra0ulred) <br />I tdi{ �pCas6df8t�� hlr <br />and Auto Liability per the attache <br />enda23 <br />adidonal Insureds with respect to General Liability <br />Rg Ti"t1(,t�jti< t;aontract insurance <br />Non -Contributory <br />is Primary and <br />2019 <br />CERTIFICATE HOLDER <br />T- <br />SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana - R sk Ma agement Division THE EXPIRATION DATE THEREOF, NOTICE WILL aE DELIVERED IN <br />4th Floor ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 I AUTHORIZED kEPResENTAVVK <br />ACbRb 2s 2016/03 -.�� 1 r R nvvnu 4VnrUKA NUIN. All rights reserved. <br />( ) Th ACORD name and logo are registered marks of ACORO <br />Printed by NLL on October 16, 2019 at 09:05AM <br />