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Francine R.
<br />Villareal
<br />Digitally signed by
<br />Francine R. Villareal
<br />Date: 2021.08.30
<br />15:39:18 -07'00'
<br />--- -1 MUtrASSQ-01
<br />.4 �� CERTIFICATE OF LIABILITY INSURANCE
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<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE BOLDER, THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BYTHEPOLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THEISSU)NOINSURER(S),AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollay(los) must have ADDITIONAL INSURER provisions or be endorsed.
<br />It SUBROGATION IS WAIVED, sublacl to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />ads certiacato does not confer ri hts to the CortlOeate bolder In lieu Of su cnnhp eNnrdorsommi 0 .
<br />PRODUCER
<br />nAMEAGT
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<br />Kali a , Jlvggina & Associates
<br />4SSIrEIMulinoAve,
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<br />628 3Sa-1035 Ig C�8 3g8.1045
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<br />Pasadena, CA 91101
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<br />24088
<br />MOGAssoclatea,tno.asuRprAmerlean
<br />1 D722 Arrow Route, Sto, R22
<br />Rancho CucamofA,CA91730
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<br />THIS IS TO 0ERTIFY 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 HESPECTTO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBCD HEREIN IS SUBJECTTO ALL THE TERMS,
<br />_EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN NECKED BY PAID CLAIMS,
<br />I SR �� TYPO OFINSURANCS BTIBn'�� pbLiY NUMBER 0 6P d IC p '� _ LIMrt9
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<br />A _X COMMEBCIALORNSRALLIMILIY aAGHOCWMENCE 1,000,
<br />OLAIMS-MADE OCCUR X X BKW57179298 71112021 7/112022 I eY.E EmEOBr, 200,000
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<br />— 3�tib 0?tb O&YLAOG LIMITAA U EVER: nENGRAL GORE E ,
<br />X pOLICYjELPi I. LOCPRAMjgTe^COM .PAGU 2,000,000
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<br />7/1/2022
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<br />Cortlfll0aie NHoIdOeIB are onamed as Additional Insured onGentlelInblliarkesobadan t rYCGOIn0041 aced onAut
<br />ry per bianket�onn COB310 041� and an Auto LIabllity Her form AC8543 0313,
<br />Gomplate Addlllonai lneurwh The City of Santa Ana, Its officora, employees, agents and volunteers, but only as respects the Insured's Operations as It ralRlee
<br />t0their alOned Contract In regards to the ODBG Administration ConsUlUng Smvlooa per form C0081004131 rlmaly Insurance and Transfer of rights or
<br />recovery against others Is Included In the farm.
<br />'30day Notice of Cancellation except iD days for non-paymDun payment or premium.
<br />City of Santo Ana
<br />Risk Management Department
<br />20 CIVIC Center Plaza, 4tb Floor
<br />Santa Ana, CA 92702
<br />SHOULD ANY OP THE ABOVE DESCRIBED POLICIES DE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />AUTHORIZED REPRESENTATIVE
<br />Thu ACORD name and logo are registered marks of ACORD
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<br />RHk Management Malysl ,-
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