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Francine R. DiI oared by Francine R. Villareal Villareal ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) o7/2112021 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 Kasey Litz NAME: Stanton and Associates Inc. PHAICNONEo Ex[: (805) 413-1498 Fax (BOS) 435-3737 A/C No : ISU Stanton &Associates E-MAIL ADDRESS: kasey@isustanton.com 3625 Thousand Oaks Blvd #319 INSURER(S) AFFORDING COVERAGE NAIL fl INSURERA: Hartford Fire Insurance Company 19682 Westlake Village CA 91362 INSURED INSURER 8: Hartford Casualty Ins CO 29424 Burke, Williams & Sorensen, LLP INSURER C: Property & Casualty Insurance Co. of Hartford 34690 444 S. Flower St., Suite 2400 INSURER D: INSURER E : Las Angeles CA 90071 INSURER F: COVERAGES CERTIFICATE NUMBER: 21-22 Cily 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 CONTRACTOR 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. INSR LTR TYPE OF INSURANCE ADDIL INSD SUBR WO POLICY NUMBER POLICYEFF MMIDDIYYYY POLICY EXP MMOD LIMITS X COMMERCIAL GENERALLIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ 1, 000,000 PREMISES ne ac PREMISES Eaccwuence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL BADV INJURY $ 1,000,000 A 72UUNUR4713 08/01/2021 08/01/2022 GEN'LAGGREGATE UMITAPPLIES PER: X POLICY 0 JECOT LOC GENERALAGGREGATE $ 2,000,000 PROOUCTS-COMPIOPAGG $ 2,000,600 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ire acadent $ 1,000,000 BODILY INJURY (Per person) $ ANVAUTO AIx OWNED BCHEDULED AUTOS ONLY AUTOS 72UUNUR4713 08/01/2021 08/01/2022 BODILY INJURY Per accidenU 1 $ HIRED X NOILOWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Peraooidem) $ $ X UMBRELLA LIM �/ X OCCUR EACH OCCURRENCE $ 10'000,OD0 AGGREGATE $ B EXCESS LIAe CLAIMS -MADE 72XHUUR4585 OB/01/2021 08/01/2022 DED )� RETENTION S 10,000 G WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY ANY PROPRIETOWPARTNERIEXECUTIVE Y❑ OFFIdatcgI NH) EXCLUDED? (Mandateryln NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 72WEP,B2915 08/01/2021 OB/01l2022 PER 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 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Hartford CGL policy form HG0001 includes Additional Insured status, Primary and Non -Contributory wording, and Waiver of Subrogation where required by written Contracts. IH 0303 - 30 Day NOC applies CG2026 —Addifional Insured — Designated Person or Organization WC 99D394 — 30-Day Notice of Cancellation to Certificate Holders WC040306— WC Waiver of Submgabon City of Santa Ana 20 Civic Center Plaza Santa Ana CA 92702 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 10i", 01988-2015 ACORC ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD RIAMovgement DtvLlm T+Y,ne" REVIEWED&ARPROVEDBY: �oaar.:4�a �.. �:�✓rrtt r_ Risk Management Analyst -