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Digitally signed by Ton <br />Tori Pierson Piet=°" <br />Date: 2022.05.11 09:40:39 <br />OTOU <br />AC p® CERTIFICATE OF LIABILITY INSURANCE <br />OA EJlJMI 02"y"Y) <br />THIS CERTIFICATE 15 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 INSURERS), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: N the Certificate holder Is an ADDITIONAL INSURED, the policy(les) 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 endorsements . <br />PRODUCER <br />NAME: NT CT Drew Martin <br />SfateFarro Drew Martin <br />PRDNC. N . EHf, 562 9434343 No , 562 9435092 <br />S First Ave <br />•oat. keren.m.brodbury.iabb@statelann.eom <br />a11129 <br />a Whittier CA 90604 <br />mSUREA S AFFORDING COVERAGE <br />NAC! <br />INSURER A: State Farm General Insurance Company <br />25151 <br />W SURED <br />INSURER B: <br />Gold Coast Appraisals Inc <br />INSURER C: <br />12440 Firestone BI Ste 2009 <br />INSURERD: <br />Norwalk, CA 90650 <br />INSURER E: <br />INSU SITE: <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 TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />TYPE OF INSURANCE <br />OD <br />a <br />POUCV NUNRER <br />POLICY PFP <br />POLICCYEXP <br />LIMITS <br />A <br />COMMERCIAL GENERAL UA91LITY <br />CLAIMS -MADE OCCUR <br />Business Policy <br />X <br />X <br />92-CK-W574-9 <br />12/0612021 <br />12106/2022 <br />EACHOCCURRENCE <br />y 1,000,000 <br />PREMIS�Ee ottu Game) <br />S <br />MEO EXP(Anone amen) <br />s 5,000 <br />I <br />PERSONA. A ACV INJURY <br />! <br />GEMLAGGREGATE LIMIT APPLIES PER: <br />POLICY 0 JECT El LOC <br />OTHER: <br />GENERAL AGGREGATE <br />S 2,000,000 <br />PROouCTs-wmplap AGG <br />$ 2,000,000 <br />s <br />AUTOMOBILE <br />ANYAUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NOWOMED <br />ALTOS ONLY AUTOS ONLY <br />COMBINED SINGLE DMR <br />Ee erdd,ed <br />p <br />BODILY INJURY(Perperson) <br />s <br />a001LY INJURY VPw eGddenl) <br />$ <br />PROPERTYOAMAGE <br />s <br />S <br />UMaRELLA DAB <br />EXCESSLWa <br />OCCVR <br />CLAIMS4MAOE <br />EACH OCCURRENCE <br />S <br />AGGREGATE <br />S <br />CEOI IRETENTIONS <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />oFFICEMMENBFR EXXCLUDEED?�UTIVE Y❑ <br />(Mandatary In NH) <br />itya+ deacree.mftr <br />DESCRIPTION OF OPERATIONS helaw <br />NIA <br />X <br />92-GA-K175-1 <br />✓ <br />07/28/2021 <br />✓ <br />0712812022 <br />PER <br />TATUTE Eq <br />EL EACH ACCmENT <br />f I,000,000 <br />ELOISEASE-EAEMPLOYE <br />S 7p00,000 <br />EL DISEASE -POLICY LIMIT <br />i 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS (VEHICLES tACORD 1016 AddlNemi Remarks Sa e, maybe attached N men apace Is raqulredl <br />City of Santa Ana, officers, agents, employees and volunteers are named as additionally insured on this policy pursuant to written contract, agreement, or <br />memorandum of understanding. Such insurance as Is afforded by this policy shall be primary, and any Insurance carried by City shall be excess and non <br />wntnbutory. <br />"it is agreed that it is the intention of the Company to provide 30 days' written notice prior to the Cancellation of the policy designated in this certificate. However, <br />the Company assumes no liability for failure to do so.• <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Division <br />AUTNO REPRESENTATIVE <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 ° ' r El M c A g <br />t- 7ou ;aree.o« <br />®1988.2016 ACORD COI <br />ACORD 251,2016M31 The ACORD name and logo are registered marks of ACORD RhIM.,dye,m.,ma�raladc <br />