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Francine R. oyu,ie,p„aerr„�,�.n <br />A� R� CERTIFICATE OF LIABILITY INSURANCE Villareal <br />- <br />,(MAI) <br />06/01/2021 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br />THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE <br />POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), <br />AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, <br />subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not <br />confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />SBC INSURANCE SERVICES/PHS <br />57129419 <br />NAME: <br />PHONE (866) 467-8730 <br />(PIC, No, Ezt): <br />FAX (888) 443-6112 <br />(A/C, No): <br />The Hartford Business Service Center <br />3600 Wiseman Blvd <br />E-MAIL <br />San Antonio, TX 78251 <br />ADDRESS: <br />INSURER($) AFFORDING COVERAGE NAIL# <br />INSURED <br />INSURER A: Sentinel Insurance Company Ltd. <br />11000 <br />Enlightened Pictures <br />INSURER B: <br />6510 MERIDIAN ST <br />INSURER C: <br />LOS ANGELES CA 90042-2939 <br />INSURER D : <br />INSURERE: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 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 <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INER <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INER <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXP <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$1,000,000 <br />CLAIMS -MADE OCCUR <br />DAMAGE TO RENTEp <br />$1,000,000 <br />PREMISES e <br />MED Ear (My one person) <br />X <br />General Liability <br />$10,000 <br />A <br />X <br />57 SBA BM0414 <br />06/30/2021 <br />06/30/2022 <br />PERSONAL B ADV INJURY <br />$1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$2.000,000 <br />POLICY ❑ PBO- E] LOC <br />JECT <br />PRODUCTS -COMPIOP AGO <br />$2,000,000 <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />ANY AUTO <br />BODILY INJURY (Per person) <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accitlent) <br />HIRED NON -OWNED <br />PROPERTY DAMAGE <br />AUTOS AUTOS <br />(Peraccident) <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAB <br />CLAIMS- <br />MADE <br />AGGREGATE <br />DED <br />RETENTION $ <br />WORKERS COMPENSATION <br />IPER <br />OTH- <br />AND EMPLOYERS' LIABILITY <br />I STATUTE <br />E <br />E.L. EACH ACCIDENT <br />ANY YIN <br />PROPRIETOWPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />NIA <br />E.L. DISEASE -EA EMPLOYEE <br />(Mandatory In NH) <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS/LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be allached If more space is required) <br />City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured per attached endorsements. General Liability <br />coverage is Primary and Non -Contributory as requiredby written contract per attached. endorsement SS 00 08 04 05 on page 17of24. <br />CERTIFICATE HOLDER <br />CANCELLATION <br />City of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />Risk Management Division <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br />20 CIVIC CENTER PLZ <br />IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />SANTA ANA CA 92701-4058 <br />AUTHORIZED REPRESENTATIVE <br />This Certificate of Insurance will provide (30) day prior written notice of <br />'r�� <br />c_ <br />cancellation. <br />© 1988.2015 ACORD CORI <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />RIA MnugenodDMsion <br />yg [REVIEWED 6pAPPRO�V/ED BYE: <br />I �NKM1 R. ��[.tJ..lPerc <br />Risk Management Analyst <br />