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DIOltalI,,I,nedby Francinefl. Francine R. Villareal Mllareal bate ]D31.0401 14:05:14-07'00' ACIISM ' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 04/01/2021 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 CONTACT EDDIE QUILLARES JR NAME: StateFarill EDDIE QUILLARES JR. PHONE 714.617.7150 uc Ani STATE FARM INSURANCE AGENCY No; hMAILss EDDI E@EDDIEQINSURANCE.COM ADDREINSURERS ISW AFFORDING COVERAGE NAICIt 415 BROADWAY INSURER A: State Farm Fire and Casualty Company 25143 SANTA ANA CA 92701 INSURED INSURER B: State Farm General Insurance Company 25151 INSURER C : TRAVEL SANTA ANA INSURER D 1631 W SUNFLOWER AVE STE C 35 INSURER E: SANTA ANA CA 92704 INSURER F: COVERAGES CERTIFICATE NUMBER: 75-0450 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, INTR TYPE OF INSURANCE ADDL SUER me POLICY NUMBER POLICY EFFrMM/DD"W MWDU/YYYY LIMITSX A COMCLAIMSMADEMERCIAL IALLIABILITY CLAIMS -MADE ❑XOCCUR Y Y 92-G5-S227-1 01/01/2021 EACHOCCURRENE $ 1,000,000 PREMI ETORENTED PREMISES Ea occurrence 300,000 $MED GEN'L EXP(Any one parson) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- ❑ LOC ECT OTHER GENERAL AGO REGATE $ 2,000,000 PRODUCTS - COMPIOP AEG $ 2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO AUTOS ONLY AUTOS HIRED NONAWNED ONLY X AUTOS ONLY Y Y 92-G5-S227-1 03/01/2021 03/01/2022 COMBINED SINGLE LIMIT Ee accident $ 1,OB0,000 RY(P., pemon) $ 1,000,000 BODILYRY IPer accldenQ $ 1,000,000 DAMAGEXAUTOS $ 1,000,000 VGATE $ UMBRELLA LIAR EXCESS LIAB OCCUR CM&MADE RRENCE $ $ DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORWARTNEWEXECUTIVE YIN OFFICER/MEMBER EXCLUDED4 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 92-G7-U822-9 03/01/2021 03/01/2022 OTH. STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 I TI DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additlonal Remarks Schedule, may be attached If more space Is required) City of Santa Ana, its officers, employees, agents and representatives are Additional Insured with respect to General Liability per the attached endorsements as required by written contract. Insurance is Primary and Non -Contributory. Cancellation Clause: City will be mailed 30 days' written notice of policy cancellation and the references "endeavor to" and "failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives" shall be removed or crossed out. CITY OF SANTA ANA RISK MANAGEMENT DIVISION 20 CIVIC CENTER PLAZA SANTA ANA 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 CA 92702 1988-2015 ACORD ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD am Rlek Mrolagtmunt D[vialaR IEWED 6r APPROVED BY:isk Management Analyit