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' 1 e <br />AFRO CERTIFICATE OF LIABILITY INSURANCE <br />°" <br />6/3012020 <br />os/3o/2020 <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, EXTEND 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; It the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement st. <br />PRODUCER <br />StateFarm Aidee Lopez, Agent <br />3750 W McFadden Avenue, Suite E <br />cOAT HANSA Aidee Lopez <br />— <br />PHONE 714-775-3090 FAX <br />M R 714-775-1778 <br />E.rXal <br />ADDRESS <br />®® <br />Santa Ana, CA 92704 <br />INSURERS AFFORDING COVERAGE <br />NAIC Y <br />INSURER A: Stale Farm Fire and Casually Company <br />25143 <br />INSURED <br />DBA Relampag° Del Cielo <br />PO BOX 3158 <br />Santa Ana. CA 92703 <br />INSURER 8: <br />— <br />INSURER D <br />MSURE0. p <br />INSU0.ER E: <br />INSURER F : <br />COVERAGES rFRTIFirATF NI IMRFR- <br />,Done <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 NOTWTHSTANDING 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, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />aDOLs <br />aR <br />POLICY NUMBER <br />MPS CYEFF <br />M�OYEXP <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />S <br />PREMISES Ea ante+ <br />S <br />CLAIMS-gADE ❑ OCCUR <br />MED EXP ers persm <br />S <br />PERSONAL a ADV INJURY <br />S <br />AGGREGATE UMn APPLIES PER <br />GENERALAGGREGATE <br />S <br />GENT <br />POLICY ❑ °Ea EILOC <br />PRODUCTS - COMPIOP AGG <br />3 <br />S <br />OTHER <br />0.OTOMOBILE <br />LIABILITY <br />COM N D ING UMIT <br />Fa 1 <br />3 <br />ANv AUTO <br />BODILY INJURY lPor W.onl <br />S <br />QWNED SCHEDULED <br />EDGILY INJURY IPer Amae.7 <br />S <br />AUTOS ONLY AUTOS <br />HIRED NON-OV.NED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />p <br />3 <br />S <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />S <br />EXCESS LIAR <br />CLUM-M SAOE <br />AGGREWTE <br />S <br />DEG I RETENTIONS <br />S <br />WORKERS COMPENSATION <br />PER OTH <br />AND EMPLOYERS' LIABILITY YIN <br />TAi Eft <br />EL EACH ACCIDENT <br />3 1.000.000 <br />X <br />ANY PROPRIETOILPARTNEWEXECUTIVE <br />OrFICERMEMBER EXCLUDED' Y <br />NIA <br />B2-GP-W9T3-4 <br />D7rD1(2D2D <br />07/Ol/2D21 <br />EL DISEASE EA EMPDYE <br />3 1,000,000 <br />IMA"clAory In NH) <br />W., Eeswm Urger <br />E L DISEASE -POLICY LIMA <br />3 1.000.000 <br />CRI>TION OF OPERATIONS Aelcw <br />I <br />yly{,prr}Z¢.x�wNla ,Sarei3a..�oRmor..P.c.x rvamroe) <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES JACORe XTv TV <br />I IYIffHIVAL L�MLIV�i <br />IS <br />oIIIYT <br />FMANCINL R. VILLAREAL <br />CERTIFICATE HOLDER r.ANrPl I ATInN <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />City of Santa Ana - Risk Management <br />AUTHORIZED REPRESENTATIVE <br />20 Civic Center Plaza <br />Santa Ana. CA 92701 <br />Completed by an authorized State Farm representative. if Signature <br />Is required, please contact a State Farm agent. <br />© 1988-2016 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />1DL'1425 132NO 13 04-22_ V20 <br />