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oPually 9gnea by Rzncme R. <br />Francine R. Villareal Mlamal <br />tiare:JVfH4FR.M:l0or0cOP ID: RORO <br />ACOROe DATE(MM/DDIYYYY) <br />CERTIFICATE OF LIABILITY INSURANCE 08/11/2020 <br />INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF <br />EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, <br />A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE <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 <br />A on this certificate does not confer rights to the <br />the terms and conditions of the policy, certain policies may require an endorsement statement <br />certificate holder in lieu of such endorsement(s). <br />CONTACT Roberta R Rosas <br />NAME: <br />PRODUCER <br />Loomis Insurance Services No" o E .951-685-7478 FAX No: 951�85-0665 <br />PO BOX 3128 E-MAIL rrosas loomis4insurance.com <br />Riverside, CA 92519 ADDRESS: <br />Michael Runner INSURERIS) AFFORDING COVERAGE NAIC# <br />INSURER A: Northfield Insurance Company 27987 <br />INSURED Adlerhorst International, LLC <br />INSURERS: <br />INSURER C: <br />3951 Vernon Avenue <br />INSURER D: <br />Riverside, CA 92509 <br />INSURER E <br />INSURER F : <br />REVISION NHMRER: <br />COVERAGES - CERTIFICATE NUMbl=K: • <br />BEEN ISSUED TO THE INSURED <br />--•- - <br />NAMED ABOVE FOR THE POLICY PERIOD <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE <br />ANY CONTRACT OR OTHER DOCUMENT <br />WITH RESPECT TO WHICH THIS <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF <br />BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED <br />CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />EXCLUSIONSAND <br />ADOL SUER POLICY EFF POLICY EXP <br />LIMITS <br />INSR TYPEOFINSURANCE POLICYNUMBER MMIDOL MM DDI <br />LTR <br />1,000,00 <br />GENERAL LIABILITY <br />X WS404241 08/08/2020 08/08/2021 <br />EACH OCCURRENCE $ <br />PREMISES Eeoccu ence $ 100,00 <br />A X COMMERCIAL GENERAL LIABILTfV <br />5,00 <br />PE(Anyone person) $ <br />CLAIMS -MADE IA OCCUR <br />PERSONONAL&ADV INJURY $ 11,000,100 <br />GENERAL AGGREGATE $ 2,000,00 <br />PRODUCTS-COMP/OP AGG $ EXCLUDED <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />$ <br />PR <br />X POLICY E O- <br />T L LOG <br />COMBINED SINGLE LIMIT <br />AUTOMOBILE LIABILITY <br />Ea accident $ <br />- <br />BODILY INJURY (Per person) $ <br />ANY AUTO <br />AUTO NED SBUTCHOEDULEDAUTOS <br />BODILY INJURY (Per accident)$ <br />PROPERTY DAMAGE $ <br />NON-0WNED <br />PER ACCIDENT <br />HIRED AUTOS AUTOS <br />EACH OCCURRENCE <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />AGGREGATE <br />$ <br />EXCESS LIAR <br />CLAIMS -MADE <br />DED RETENTION $ <br />WC STATU- OTH- <br />WORKERSCOMPENSATIONTORY <br />LIMITS ER <br />E. L. EACH ACCIDENT <br />$ <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNEWEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? ❑ <br />NIA <br />E.L. DISEASE -EA EMPLOYE <br />$ <br />E.L. DISEASE -POLICY LIMIT $ <br />(Mandatory in NH) <br />Ryes, describe under <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS/ LOCATIONS [VEHICLES (Attach ACORD 101, Additional Remarks Schedule, Hmme space is required) <br />City of Santa Ana Risk Management Division is named as Additional Insured <br />with regards to services rendered by the Named Insured as required by <br />written contract. Coverage is Primary and Non -Contributory. Insurer shall <br />a <br />provide 30 written notice of cancellation. <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th FI <br />Santa Ana, CA 92701 <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 (2010105) <br />© 1988-2010 ACORD CC <br />The ACORD name and logo are registered marks of ACORD <br />Rusk Nfanageme€itAn*V <br />