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_ Digitally signed
<br />//�� l� ff P� RI-01 PPOR'
<br />,a►`oJzo CERTIFICATE OF LIABILITY INSl7RA'I�C by , �; 7t7�99 '
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS/�OCI,GJ�T�l��1 �iF�R �'CATE O S
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALj�i(TH�-CQy�U E AF.`R,QA 'E' J �S
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT B H i1'MSURE^^R�I SS), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. _ 10 / : 1 7 -0710(
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 />PRODUCER
<br />PIASC Insurance Services, Inc.
<br />5800 S. Eastern Avenue
<br />Suite 400
<br />Los Angeles, CA 90040
<br />INSURED
<br />Mekong Printing, Inc.
<br />Hoan Truong
<br />2421 W. First Street
<br />Santa Ana, CA 92703
<br />COVERAGES CERTIFICATE NUMBER: RFVISION NIlMRFR-
<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 />ADDL
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXPLTR
<br />LIMITS
<br />A
<br />X
<br />COMMERCIALGENERN. LIABILITY
<br />CLAIMS -MADE I OCCUR
<br />GL BROADEN ENDT
<br />ZH39145865.11
<br />5/1912022
<br />511912023
<br />EACH OCCURRENCE
<br />1,000,000
<br />DAMAGE TO RENTED PREMISES (Ea occurrence)
<br />MEO EXP An one arson
<br />700,000
<br />X
<br />DEVIL
<br />X
<br />10,000
<br />PERSONAL&ADV INJURY
<br />1,000,000
<br />AGGREGATE LIMIT APPLIES PER
<br />POLICY❑JECT LOG
<br />OTHER:
<br />GENERAL AGGREGATE
<br />2,000,000
<br />PRODUCTS-COMPIOP AGG
<br />Included
<br />Emp. Ben.
<br />1,000,000
<br />B
<br />AUTOMOBILE
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />AW39147434
<br />5/1912022
<br />511912023
<br />COMBINED SINGLE LIMIT
<br />Ea accident)
<br />$ 1,000,000
<br />BODILY INJURY Perperson)
<br />$
<br />BODILY INJURY Per accident
<br />$
<br />l20PERTY AMAGE
<br />Per accitldY
<br />$
<br />A
<br />X
<br />UMBRELLA LIAR
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIM&MADE
<br />UH3 9091550 11
<br />5119/2022
<br />5/19/2023
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />1,000,000
<br />DIED I X I RETENTION$ 0
<br />C
<br />WORKERS COMPENSATION
<br />ANDEMPLOYERS'LIABILITY YIN
<br />ANY PROPRIETOeRRIPARTNER]EXECUflVE ❑
<br />IMantlaMryin NR( EXCLUDED?
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />EIG287806902
<br />7/1/2021
<br />71112022
<br />PER OTH-
<br />X TUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,Ogp
<br />E.L.DISEASE-EA EMPLOYE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />A
<br />Printers Errors
<br />ZH3 9145865.11
<br />5119/2022
<br />5119/2023
<br />& Ommisns Ded: $1000
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, ma be attached if more space is required(
<br />The City of Santa Ana, it's officers, employees, agents and representative are namewas Additional Insured in regards to General Liability per COMMERCIAL
<br />GENERAL LIABILITY SPECIAL BROADENING & ENHANCEMENT ENDORSEMENTS
<br />"PROOF OF WC COVERAGE ONLY"
<br />The City of Santa Ana Attn:Risk Management Division
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702
<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 />AUTHORREO REPRESENTATIVE
<br />91
<br />ACORD 25 (2016103) 01988-2015 ACORD
<br />The ACORD name and logo are registered marks of ACORD
<br />% PJekMrmagemadptWe(Dn
<br />RENEWED & APPROVED BY:
<br />A+-gt, ACIW44
<br />��Risk Management Spedaint
<br />01
<br />
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