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Francine R. Ulge111111 ed by Finadmc <br />R. ith ai <br />Villareal Dale:3a31D1.nq 1&A4A6 <br />AC" Ra CERTIFICATE OF LIABILITY INSURANCE <br />°12123122o 0Y' <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: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the <br />terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER Eddie QUIIIares Jr. <br />State Farm Agency <br />N. Broadway <br />� Santa Ana, CA 92701 <br />IN Santa <br />CONTACT <br />NAME: Eddie QUIllare5 <br />PAM. No.HONE 71 .7150. ac No:71a 17.7158 <br />aDDRESs: addle@eddleginsurance.com <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURERA: State Farm General Insurance Company <br />25151 <br />INSURED ROmo Enterprises Inc. <br />DBA Orange County Maintenance Services <br />1191 La Limonar Rd <br />Santa Ana, CA 92705 <br />INSURER B: State Farm Fire and Casualty Company <br />25143 <br />INSURER C: <br />INSURER D: <br />INSURERS: <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 75-0450 REVISION NUMBER: <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. NOTWITHSTANDING 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 TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INBR <br />LTR <br />TYPE OF INSURANCE <br />ADOL <br />SUER <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDIYYYY <br />POLICY EXP <br />MMIDDIYYYY <br />LIMITS <br />A <br />GENERAL LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE 1XI OCCUR <br />X Loss of Income <br />Y <br />Y <br />92-GJ-X588-2 <br />01/02/2021 <br />01/0212022 <br />EACHOCCURRENCE <br />$ 11000,000 <br />RA -MAX <br />PREMISES ca occurrence) <br />PREMISES Ea occurrence <br />$ 300,000 <br />MED EXP(Any one person) <br />$ 5,000 <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GEN'L AGGREGATE LI MIT APPLIES PER: <br />POLICY PRO 7LOC <br />PRODUCTS - COMPIOPAGG <br />$ 2,000,000 <br />$ <br />A <br />AUTOMOBILE <br />X <br />1$ <br />LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />HIRED AUTOS X NONAWNED <br />AUTOS <br />❑ <br />❑ <br />606 0191-F20.75 <br />1212012D20 <br />06/20/2021 <br />EOMae�I INEe01SINGLE LIMIT <br />$ 1,000,000 <br />BODILY INJURY (Par person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY -DAMAGE <br />Pereccidenl <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OR <br />OCCUR <br />❑ <br />❑ <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED RETENTION$ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY YIN <br />ANYPROPRIBER EXCLUDED? <br />In NH EXCLUDED9 Y� <br />(Mantlabry In NH) <br />(MandaOFFICEtory <br />under <br />If yes, DESCRIPTION <br />N/A <br />� <br />92-GF-L870.7 <br />0110112021 <br />01101/2022 <br />I WC STATU- X OTH- <br />TORYLIMITS <br />1,000,000 <br />EL EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYE <br />$ 1,0001000 <br />EL DISEASE -POLICY LIMIT <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach AC ORD 101, Additional Remarks Schedule, if more space is required) <br />Pressure washing Services of the 2nd Street Promenade in Downtown Santa Ana. <br />City of Santa Ana its officers, agents, employees and volunteers are named as additional insured. <br />Additional Insured endorsement issued for certificate holder with Wavier of Subrogation and non-contributory <br />Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation <br />CITY OF SANTA ANA <br />RISK MANAGEMENT DIVISION <br />20 CIVIC CENTER PLAZA 4TH FLR <br />SANTA ANA, CA 92702 <br />CANCELLA <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 />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2010ti The ACORD name and logo are registered marks of ACORD <br />RlekMmygementDivision <br />REVIEV/ED&APPROVBJBY: <br />``�� �datMrt+hl R. V:k�uetC <br />00 <br />t <br />Risk Management Analyst <br />