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CERTIFICATE INN JDATE (M'NDp1Y'YVby <br />05/31/2022 <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 CCNTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder i an ADDITIONAL INSURED, the policy(ie) must have ADDITIONAL INSURED provisions or be endorsed. <br />if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endor ment(s). <br />PRODUCER CO CT TEID <br />FBOWERSOX <br />t wTrm TED BOWERSOX <br />�Payrxran ___- <br />A/C, N949 61 32fO <br />94,9 <br />661 4 I <br />b 24681 LA PLAZA, #360 E-MAIL <br />....._ <br />_ADD <br />DANA POINT, CA 92629 1�S _ .... ..... <br />INSURED <br />,TAMES GARTNER & ASSOCIATES ARCHITECTS, IN <br />2036 N BROADWAY <br />SANTA ANA, CA 92704 <br />INSURi A State Farrra Fire and <br />INSPIRER B <br />- I INSURER <br />OVERAGES CERTIFICATE NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN <br />INDICATED. NOTWITHSTANDING, ANY REQUIREMENT,, TERM OR CONDITION OF ANY <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY T <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN RE <br />_AD� _ _ <br />R TYPE OF INSURANCE 11G 11N1f POLICY' NUMBER <br />COMMERCIAL GENERAL LIABILITY � �� <br />CLAIMS -MADE 1_71 OCCUR <br />GEN`L AGGREGATE LIMIT APPLIES PER: <br />POLICY 1..� PRO- <br />JECT LCC <br />OTHER: <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />OWNED SCHEDULED <br />.AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />.AUTOS ONLY AUTOS ONLY <br />UMBRELLA LfAB OCCUR <br />EXCESS LIAR CLAIMS -MADE <br />DED RETENTION $ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y f N' <br />ANY PROPRIETOR7PARTNERIEXECUT€VE <br />A OFFICER/MEMBER EXCLUDED? N I A <br />(Mandatory in NH) N <br />(f yes, describe wander <br />92-MW-F864-4 ! 01 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be <br />30 DAYS NOTICE OF CANCELLATION, EXCEPT 10 DAYS CANCELLATION FOR NC <br />Mmffw�r r <br />REVISION NUMBER: <br />SUED TO THE INSURED NAMED ABOVE FOR THE POLICY PE <br />NTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH <br />POLICIES DESCRIBED HEREIN IS SU13JECT TO ALL, THE TE <br />'ED BY PAID CLAIMS, <br />EACH <br />MED EXP {Any one person) <br />PERSONAL A ADV INJURY <br />GENERAL AGGREGATE, <br />PRODUCTS COMPIOPAGG <br />BODILY IN_JURV <br />BODILY 6NJURY <br />EACH OCCUF <br />AGGREGATE <br />01F2212023 [E.L. EACH ACCIDENT <br />E L DISEASE EA EMPLOYE <br />E., L. DISEASE - POLICY LIMIT <br />:d if more space Is required) <br />YMENT. <br />$. 1,000, 000 <br />$ 1,0OO,000 <br />SHOUL ANY OF THE ABOVE DESCR18EU POLICIES BE CANCELLED BEFORE <br />THE E PIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />CITY OF SANTA ANA RISK MANAGEMENT DIVISION ACCOR ANCE WITH THE POLICY PROVISIONS. <br />20 CIVIC CENTER PLAZA ---- <br />AUTHORIZE D REPRESENTATIVE <br />SANTA ANA, CA 92701 u, -Risk w ni%bion. <br />REmEwED <br />a <br />& ED RYr <br />Q 1988-2015 ACORD C( <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />1001486 132648.14 04-13-202.2 <br />