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Francine R. o" ul ' °b ACORN Villareal isrzestae as CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/VVVV) 09/16/20 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 MARK JACKSON INSURANCE AGENCY, INC P.O. BOX 775 YORBA LINDA, CA 92885 CONTACT MARK JACKSON PAME HONE we No Ew : (714)779-2629 wc, No 1714)779-1170 ADDRESS MARK@MARKJACKSONINSURANCE.COM License#:OK12422 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A MERCER INSURANCE COMPANY 14478 INSURED INSURER B SUNSERI'S BEEF INSURER C -3623V— PO BOX 83 INSURER D GLENDORA, CA 91740 NSU HER 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. INSF LTR TYPE OF INSURANCE INSD VVVu POLICY NUMBER MM/DD/VVVV MM/DD/VVVV LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE C OCCUR PREMISEU MACES Ea occHENurrence $ 100,000 A Y Y 60475363-2 4/16/2020 4/16/2021 MED EXP(Anyerson) $ 5,000onep X LIQUOR LIABILITY PERsoNALa ADV INJURY 1,000,000 $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY C PRO CI LOC ECT PRODUCTS -COMP/OP AGO $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINurrTTgT— Ea accident)$ 2,000,000 BODILY INJURY (Per person) $ B SCHEDULED LY X AUTOS 04348527-9 4/16/2020 4/16/2021 BODILY INJURY (Per accident) $ X X NONOWNED$ LY AUTOS ONLY Per accitlent LEXCESS LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ IAB CLAIMS -MADE RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y'" PARTNER, L ANY PROFFICEROPRIETOR, EXCLUDED, (mammant, in NER EXCLOOEO4 In Nrv) (f NIA Y ON09646-01 4/1 /2020 4/1 /2021 X - STATUTE ER E.L. EACH ACCIDENT $ 150005000 E.L. DISEASE - EA EMPLOYE $ 150005000 yes, describe It yes, DESCRIPTION DESCRIPTION OF OPERATIONS below OF O E.L. DISEASE -POLICY LIMIT $ 150005000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attacked i1 more space is required) BARTENDING / CATERING / WHOLESALER / ALL LOCATIONS THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, AND REPRESENTATIVES ME AUTOMATICALLY NAMED AS ADDITIONAL INSUREDS INCLUDING PRIMARY AND NON-CONTRIBUTORY COVERAGE, WAIVER OF SUBROGATION WITH RESPECT TO THE GENERAL LIABILITY, LIQUOR LIABILITY POLICIES PER END CG71030215 AND CGM010413 WHEN REQUIRED BY CONTRACT. WORKERS COMPENSATION BLANKET WAIVER OF SUBROGATION PER END 10217. RISK MANAGEMENT DIVISION 20 CIVIC CENTER PLAZA, 4TH FLOOR SANTA ANA, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Mk ©1988-2015 ACORD ACORD25(2016/03) The ACORD name and logo are registered marks of ACORD — "..Ivrvmwrr Z REVIEWED BY: r ® Risk Management Analyst