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�Ro CERTIFICATE OF LIABILITY INSURANCE <br />Diiiis o19 <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, EMEND 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 be endorsed. If SUBROGATION IS WAIVED, subject to the <br />terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsoment(s). <br />PRODUCER Eddie Quillares Jr. <br />State Farm Agency <br />415 N. Broadway <br />19661 Santa Ana, CA 92701 <br />LEijINSURER <br />CONTACT <br />AM : Eddie Quilieres <br />- <br />PNDNE 0 714 617 7150 FA c Nei: 714.6 <br />MAIL E- <br />O eddieglieddleginsurance.corn <br />INSURE 3 AFFORDING COVERAGE <br />HMCo <br />A: State Farm General Insurance Company <br />s <br />INSURED SANTA ANA BUSINESS COUNCIL, INC. <br />400 E 4TH ST <br />SANTA ANA, CA 92701-4666 <br />INSURER 0: State Farm Fire and Casualtym n <br />INSURER c: <br />INSURER O: <br />INSURER E <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 754450 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 TERMS. <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSA <br />TYPE OF INSURANCE <br />SUSIR <br />POLICY NUMBERLICY <br />EFF YYYI <br />PMLX:Y P IDDNM <br />LMRS <br />A <br />GENERAL LIABILITY <br />Y <br />Y <br />92-GT-PO08-7 <br />12/01/2019 <br />121OV2020 <br />EACH OCCURRENCE <br />i 1.000.000 <br />PREMISESIEGaxarazeI <br />300,000 <br />X COMMERCIAL GENERAL LIABNtt <br />ClA1M5 ADE OCCUR <br />MEDEXP( ..pawn) <br />S 5.000 <br />PERSONAL a ACV IMURY <br />$ 1,000,DOO <br />X BUSINESS INCOME <br />GENERALAGGREGATE <br />S Z000.000 <br />GEMLAGGREGATEUMR APPUESPER <br />PRODUCTS-CONPPOPAGG <br />S 2,000.000 <br />S <br />X POLICY PP0. LOC <br />A <br />AUTONOBILELJMILITY <br />6215237-F28-75 <br />12101/2019 <br />12101/2020 <br />eaa e. uMl <br />s <br />BODILY INJURY (Per p*rt ) <br />S 1.000.000 <br />ANY AUTO <br />BODILY INJURY(Paaad0en0 <br />S 1.000.000 <br />ALL OvMEO X SCHEDULED <br />NPOM <br />HIRED AUTOS AAUUTOS � <br />Par e£madeerrrl <br />S 1.000.000 <br />s <br />UTABRELLA WB <br />OCCUR <br />EACHOCCURRENCE <br />S <br />AGGREGATE <br />S <br />EXCESS UAB <br />CUUMS.MAOE <br />OED RETENTIONS <br />S <br />B <br />WONMRS COMPENSATION <br />ANOEMPLOYERSUAaLL1TY YIN' <br />ANY PROPRIETDRIPARTNERlFYEOUTYE <br />OFFICHMEMB£R EXCWOED> <br />[a WAay MNID <br />NIA. <br />92.GT-P014.9 <br />1210112019 <br />12101/2020 <br />NC STATLL X OTH- <br />1,000.000 <br />ELE <br />1.00O.ODD <br />Y <br />EL DISEASE -EA EMPLOYE <br />S 1.000000 <br />EL DISEASE -POIICY OMIT <br />S 1,000.ODO <br />11 yet. awaeuMer <br />A <br />DIRECTORS ANDOFFICFAS LUU31UTY <br />EMPLOYEE PROFESSIONAL UABIUTY <br />Y <br />Y <br />259034 <br />12/01/2019 <br />12/01/2020 <br />SIODD'OOD <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Aeach ACORD 101, Addlaaal Ram A, acaedu . It m m aura Is mu§ dl <br />Location: Plaza Calls Cuabo, East End Promenade, 100 East Alley, 200 East Alley, East End Promenade, 400 West 4th IEWED &APPROVE <br />City of Santa Ana its officers, agents, employees and volunteers are named as additionally insured. <br />Additional insured endorsement issued for certificate holder YAM waiver of subrogation and non-contributory. B Risk M ACIEMENT DIVi510 <br />ft <br />Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation <br />2019 <br />CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />RISK MANAGEMENT DIVISION ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 CIVIC CENTER PLAZA 4TH FL <br />SANTA ANA, CA 92702 AUTHORIZED SENTATNE <br />01 -2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010105) The ACORD name and I re registered rks of ACORD 1001486 132849.7 03-01-2012 <br />