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AC o)Rht CERTIFICATE OF LIABILITY INSURANCE ATE(M" N 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: H the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, 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 4242 Obispo Ave Lakewood CA 90712 CO NAME PHONE PAX ac Not. EMAIL AD ESS� INSURERS AFFORDING COVERAGE NAIC# INSURER A :State Fund INSURED Casa De La Familia Inc INSURER B; 1650 E 4th St INSURER c Hudson Insurance INSURER 0: 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 TR TYPEOFINSURANCE ADDL Mean UBR WVn POLICYNUMBER POLICY EFF D Ir POLICY EXP MM D(YYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ PREMISES Ee oxam nce $ CLAIMS -MADE ❑ OCCUR MED EXP JAry oneperson) S PERSONAL A ADV INJURY 5 GEML AGGREGATE LIMIT APPLIES PER. GENERALAGGREGATE 3 POLICY 0 JE'T LOC PRODUCTS -COMPIOP AGO S 5 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S BODILY INJURY (Per person) S ANY AUTO OWNED AUTOS ONLY BODILY INJURY(Per accident) 5 PROPERTY DAMAGE (Per acial S HIRED AUTOS ONLY tC�IMS-�DE UMBRELLALUIB EACH OCCURRENCE S AGGREGATE 5 EXCESSUAS DED I RETENTION 5 S Z A WORKERS COMPENSATION ( I PER OTH- AND EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNER/EXECUTIVE YIN OFFICERMEMBEREXCLUDED? (Mandatory In NH) NIA 248318-19 3l23/2020 3I23/2D21 E.L. EACH ACCIDENT 51,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT S1,009,000 If yes, describe under DESCRIPTION OF OPERATIONS below C Employer Liability 100,000 Retention Includes -Sexual Misconduct Liability FP-HN-NPP-3783 2/1712019 1211712020 1,000,000 Aggregate —11 Employer Practices DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required) REVIEWED & APPROVE By RISk MANACIEMENT DIVISI ertificate Holder Listed as Additional Insured JUL 0 2020 CERTIFICATE HOLDER CANCELLATION Ah,;r, Arrvcrin iof Santa Ana 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 AUTHORIZED REPRESENTATIVE 01988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Produced using Forma Boss Web software. w FormsBoss.com; If Impresslas Publishing 800-2011-1977