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olgmlly sgmd by Ton Pierson
<br />Tori Piersonp°Isn.12..D 13:I3:38
<br />07W
<br />A� CERTIFICATE OF LIABILITY INSURANCE
<br />°4/07i 022
<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 DARRYL NIND INSURANCE AGENCY
<br />4378 EILEEN ST
<br />SIMI VALLEY, CA 93063
<br />t
<br />NAME. DARRYL NIND AGENT
<br />PHcoNN 805823-8373 1 ac No: 805823-8377
<br />EMDOAIL
<br />ARess:dar l.nind.rebiGstateferm.com
<br />INSURERS AFFORDING COVERAGE
<br />NAIL If
<br />INSURER A: State Farm General Insurance Company
<br />25151
<br />INSURED VENTURA BUSINESS SYSTEMS, INC
<br />C/O TREVOR YATES
<br />2582 FIG ST
<br />SIMI VALLEY CA 93063-2416
<br />INSURER : State Farm Mutual Automobile Insurance Company
<br />25178
<br />INSURER C:
<br />NSURER D:
<br />INSURERE:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMRFR-
<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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDLSUB
<br />POLICY NUMBER
<br />POLICY EFF
<br />MWDD
<br />POLICY EXP
<br />MMIOO
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMB-MADE IOCCUR
<br />❑
<br />❑
<br />92-W4-0493-7
<br />04126/2022
<br />04/26/2023
<br />1,000,000
<br />$
<br />$ 5,000
<br />n$
<br />rAL
<br />$ 1,000,000$
<br />2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />X POLICY PR0.El LOG
<br />$ 2,000,000
<br />$
<br />B
<br />AUTOMOBILE
<br />X
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />HIRED AUTOS AUOTNOSWNED
<br />❑
<br />❑
<br />051 5512-AIB-75N
<br />01118/2022
<br />07/18/2022
<br />IWNGLE LIMB
<br />$
<br />BODILY INJURY (Per person)
<br />$ 1,000,000
<br />Y I )
<br />BODILY (Per accltlent
<br />$ 1,000,000
<br />(Perrac ident OPERTY -DAMAGE
<br />$ 1,000,000
<br />UMBRELLA LIAR
<br />EXCESS LIAR
<br />OCCUR
<br />CLAIMS -MADE
<br />❑
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />DED I I RETENTION$
<br />$
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETORIPARTNER/EXECUTIVE
<br />OFFICUMEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS Imbry
<br />N/A❑
<br />WC STATU- OTH-
<br />O E
<br />E.L. EACH ACCIDENT
<br />$
<br />E.L. DIBEABE-EA EMPLOYE
<br />$
<br />E.L. DISEASE -POLICY LIMIT
<br />$
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Addith nal Remarks Schedule, if more space is required)
<br />There is no Workers Compensation policy for Ventura Business Systems as all employs are officers of the corporation. Officers of the Corporation are
<br />not required to have a Work Comp policy in the State if California.
<br />ADDITIONAL INSURED: City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza, 4th floor
<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 />ptl'IYIBRIZEDR RE NTATIVE Rlai Msr�mw{Dhidon
<br />/,(f/// Ren[wm6MPRw® er. r
<br />d� Jj ''. %du Pecwdx
<br />I
<br />U 1988-2U1t1 ACORD CC
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ,,,,, ,,,,, ,,,_.. ,,, _„ .0
<br />
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