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acoRo® CERTIFICATE OF LIABILITY INSURANCE 414.� DATE(MMIDD/YYYY) 1 06/24/2020 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(ies) must have ADDITIONAL INSURED provisions or 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 Tom Saumur Insurance Agency CONTNAME, 4242 Obispo Ave PHONE FA% fAIC. No. Eldh c Not; Lakewood CA 90712 EMAIL Do SS, INSURSIUSH AFFORDING COVERAGE NAIC# INSURER A:State Fund INSURED Casa De La Familia Inc INSURER 8: INSURERC:Hudson Insurance VZ 1650 E 4th St INSURER D: Santa Ana Ca 92701 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 LTR TYPE OF INSURANCE A L SUBR POUCYNUMBER POLICY EFF IMMIDDNYWI POLICY EKP (MINIODArYYY1LIMITS COMMERCIALGENERALUABILITY EACH OCCURRENCE S PREMISES Me oncurv..)S CLAIMS -MADE OCCUR MED EXP one arson S PERSONAL B ADV INJURY S GENT AGGREGATE LIMIT APPLIES PER POLICYO jERC ❑LOC GENERALAGGREGATE S PRODUCTS-COMPIOPAGG S S OTHER: AUTOMOBILELIABILRY COMBINED SINGLE LIMIT Me arediderill S ANY AUTO BODILY IWURY(Per person) S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INLARY(Per a I, ilkM) S PROPERTY DAMAGE S HIRED NONOWTlED AUTOS ONLY AUTOS ONLY S UMBRELLA LMB OCCUR EACH OCCURRENCE S AGGREGATE S "LESS L1118 CLAIMS -MADE DIED I I RETENTION S S (A WORKERSCOMPENSATION AND EMPLOYERS' UABILRY ANYPROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMSERMLUDED9 Y❑ (Mandatory In NN) NIA 248318-19 1312312020 3123/2021 ✓ PER T OTH- E.L EACH ACCIDENT S1,000,000 E.1- DISEASE -EA EMPLOYEE $1,000,000 ifyea, describe under DESCRIPTION OF OPERATIONS below EL.DISEASE - POLICY LIMIT $1,000,000 C rinployer Liability 100,000 Retention ncludes-Sexual Misconduct Liability FP-HN-NPP-3783 2/17/2019 2/17/2020 1,000,000 Aggregate Employer Practices DESCRIPTION OFOPERATK)NS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe aeached if more space Is mgubad) REVIEWED & APPROVE By Risk MANAGEMENT DiVis1 ertificate Holder Listed as Additional Insured JUL 9 2020 CERTIFICATE HOLDER CANCELLATION Aaicic Arcvcrin iof Santa Ana , / V SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Risk Management Divison THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 0 Civic Center Plaza 4Th Floor ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, Ca 92701 AUTHO W 2ED REPRESEMAI W E ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Produced using Forma Bass Web softeme. www.FormsBoss.wm; 9 Impressive Publishing 809-208-1977