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ri-ancine Fla ncine R.VilIareaI <br />late: 2 <br />R. Villareal 09:07,02-08'00'3 <br />Phone:(714)647.5420 Fax:(714)647.6944 <br />CERTIFICATE OF LIABILITY INSURANCE <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($), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE HOLDER <br />:ertiiCate holder Is an AUDITIONAL INSURED, U* P <br />WAIVED, subject to the terms and conditions of the <br />PRIMUCEr` Triton of Calif Insurance Services, Inc. <br />5000 San Juan Avenue <br />Fair Oaks, CA 95628 <br />License #: OF41767 <br />TOM BYSTRY 1 <br />DBA: VIDEO ENGINEERING SERVICES <br />14 APPOMATTOX <br />IRVINE, CA 92620 <br />must have ADDITIONAL INSURED provisions Dr be endorse <br />attain policies may require an andomemenL A statementon <br />Chris <br />.___ INSURF_H(S)AFFOROWO COVEMGE <br />COVERAGES CERTIFICATE NUMBER: 00003262.93AR RFUIRInM MIIMRPR• " <br />THIS ISTO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE OWED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />Oak <br />IN6R TYPE OF INSUPMICEsil N#Fmt1CYwmm <br />A <br />X <br />COMMERCOLLDBIERALUAeRRY <br />cuwsJAaDE ❑X occuR <br />Y <br />MP0004009006721 <br />� <br />02/01/2020 <br />OV0112021 <br />EACH=MRENCE <br />s 1,001000 <br />Ea ooa <br />s 100 000 <br />MEDEWWWu <br />s 5000 <br />CENL <br />PERSOHALaAWIWURY <br />6 1000000 <br />AGdF1EOATE UTATAPPLIEB PER <br />PGICY ❑ J ❑Lac <br />OTHER: <br />GENERALACCFEGLTE <br />PRODU(;M-COMPA Aoo <br />6 2000000 <br />s 2,000,000 <br />6 <br />AUTOMOBILE <br />LABILITY <br />ANY AUTO <br />OWNED <br />ALTOS MY �O6 EOULED <br />HIRED 1404-0L <br />AVTO6 ONLY AUT09ONLY <br />r <br />COMB <br />6 <br />BO1)ILY1NIURY(PupuxP,l <br />1 <br />BODILY IWURY (PeI ACGdRq <br />6 <br />--. <br />S. <br />i <br />UMBREWI WLB <br />EXCESS LAS <br />OCCUR <br />CLAIM L <br />j <br />I <br />EACH OCCURRENCE <br />6 <br />AGGREGATE <br />$ <br />DELI I I RETENn)N6 <br />6 <br />iNORKBRS CONPENMTRNI <br />ANOF,MPLOTERYLIASILRY YIN <br />FFl BER ARTNEWEXOY ECIRIVE <br />tLYynwle MNHl <br />CESCRIPrgN OF OPERATIONS Wbw <br />NIA <br />PEA <br />ELEAGHACGDENT <br />6 <br />EL DISEASE -EA EMI Y <br />6 <br />EL MSEASE-POLICY UVR <br />6 <br />I <br />DESCMPnM dF OPEMTIONS I LOCAnO l VEIOCIFA (ACORO f01, AdSIwu1 Rwwhv BswEUM, nuYOr JwcME it,Ao,R rpu W RWw� <br />The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; Its officers, employees, agents and representatives <br />are named as additional Insureds per CG2010 attached to this policy. The insurance is primary and noncontributory. <br />Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation <br />REVIEWED 81 APPROVED <br />FE Q ZO2O SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City Of Santa Ana THE M(FIRATION DATE THEREOF, NOTICE WILL SE DELIVERED IN <br />Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza, 4 <br />SANTA ANA, CA 92702 ANGiP ACEvEdo "TMOR�D 'AE <br />CPR <br />®1988-2015 ACORD CORPO <br />ACORD 26 (2016103) The ACORD name and logo are registered marka of ACORD Rhk MRnagenLRdDtvieton <br />Pdnted by CPR onJ -"a <br />`.i ccREVIEWED&ppAP,P`RI�C�IV'/ED BY.' <br />'� rAhK�-h6 Yam. I<+L!lHEJLL <br />v Risk Management Analyst <br />