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A`� CERTIFICATE OF LIABILITY INSURANCE °04/23/20 0 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER State Farm Insurance: Wendy Truong 9011 Garvey Ave. Suite B �L Rosemead, CA 91770 W t CON NANEAC MARITZA TINAJERO RNGNE C. No: (6261382-1496 EAo-0DRL Marilza.Tina em.uzlm statefarm.com j._. INSURERISI AFFORDING COVERAGE RAN: INSURER A: State Farm Mutual Automobile Insurance Company 7R INSURED Jennifer Cammack / DBAA&PortabieRestroom !/ 31942 Via Oso Trabuco Cyn, CA 92679-3900 INSURER B: INSURERC: INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NIIMRFR• ecvlanu wuaecm. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TR TYPE OFINSURANCE ADDL POLICY NUMBER POLICY EFF POLICY EXP LIMBS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑OCCUR REMI9 p S MED EXP JAnyone Wool S PERSONAL R ADV INJURY $ GENERAL AGGREGATE S GENL AGGREGATE POLICY LIMIT APPLIES PER: PROL� 7 PRODUCTS-COMPrOPAGG $ S A AUTOMOBILE LIABILITY Y COMBINED SINGLE LIMIT Ea eccxl. O S 1,000,000 BODILY INJURY (Per Person) S x ANY AUTO ALL OWNED SCHEDULED AUTOS x AUTOS HIRED AUTOS NON -OWNED AUTOS Como- 100 x Col.: 100 475-9570-AO9.75A 07/09/2019 r/ 0771020 BODILY INJURY (Per accident) S PROPERTY DAMAGE Peraccldenl s $ UMBRELLA LIMB OCCUR EACH OCCURRENCE $ B EXCESS LA CLAIMS-MADE AGGREGATE S DED RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILnY ANY PROPRIETORIPARTNERIEXECUTIE YIN OFFICEIMEMBER EXCLUDED? MIA WC STATLL OTH- ER EL EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatary in NH) V yes. desvlba undx EL. DISEASE -POLICY LIMIT $ A UMec$z3.500m500.OBo UMPD: $8.500 Y 475.9570-A09.75A 07/09/2019 07/0912020 MED. 5,000 OESCM"ONOFOPERATIONSILOCATIONSIVEHICLES(Attach ACORD101.Addidwal Remarkssehaduk,Hmora.Paeaismwjl ) VEHICLE(S:) 2007 ISUZU NPR FLATBED VIN: JALC4B16577000723 017 DODGE 5500 TANK VIN:3C-iWRMDL8HG760781 20191SUZU NPR -HD- TANK TRK VIN: 54OC4W165KS80024 2006 GMV STAKE TRUCK VIN: J8D84B16667019792 City OF Santa Ana, officers,agents, employees, 1¢ v I e rM n0LN ��QjtipOalty insured on this policy pursuant to written Contract, agreement, or memorandum of understanding. Such insuranc I I primary, and any insurance Carried by City Shall be excess and noncontributory. By RISk MANAGEMENT IVISION City of Santa Ana •� Risk Management Division 20 Civic Center Plaza Santa Ana, Ca 92702 ACORD 25 (2010105) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE v E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EdQ ANGIE ACEVACCORDANCE WITH THE POLICY PROVISIONS. TINAJERO 21198E All A.kk rn--A The ACORD name and logo are registered marks of ACORD 1001486 132849.5 10-22-2010 W