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A`"Rly CERTIFICATE OF LIABILITY INSURANCE °" (W" M" NY 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: H the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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($). j,y�p�q �y PROVeracity DUCER Insurance Solutio ,LLC. Di v 4yP'�47r6 31H °Angie.. - _ - V �/-�! IggA__c,,,,,N�P�,,I1 u. C Ipac.IgX (801}763.1374 ea,gic``SI-A ce W e�d O AC 1Y ICCi� infoQauinsurance_com ��✓JJINSURER(SI AFFORDING COVERAGE Da Ie02ii4:A'fk�y001_ 26832 -- R INSURED INSURER a: — EmmY Lam INstmEac: —� 1465 Tamarind Ave. #565 INSURER D: Los Angeles CA 90D28 wsuaFx E: INSURER F: rrnVRRAGFR CPRTIPWATP MIIMRGR• RCVIRVYM MIIMRFR• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MaR T L`$URY iFC I EFF POLICY FXP � L TYPE OF INSURANCE i POLR:YNUMSER LaaTS GENERAL LIABILITY EACH OCCURRENCE S 1.0DO.000 X COAWERCIAL GENERAL /MIBRITY GENE j � '.1�"" f OAMAGETORENIEO �0D0 r PREMISES lEs ocanremR) S CERCM X OCCUR I I 4 MED EXP (Ate r P t S 5,000 A _ _ � PLE957546-AS286141 OS115l2024 � 0511712024 �ttII , � _ PPx9oNa anov lwuav s EXCLUDED dENERAL AGGREGATE S 2,000,000 ORNL AGGREGATE LART APPLIES PER. If PRODUCTS. COMPOP AGG S EXCLUDED_ X POLICY L P Loc I ANIMAL BAILEE 3 AUTOMOBILE LIABILITY ANY AUTO SOD0.Y INJURY (Pr pi~) S ALL OWNED SCHEDULED AUTOS �1AUTOS j BODAY I INJURY IWr AEU S NONED PROPERTY DATUCE f VIREO AUTO f_ AUTOS Ift APaNpI. OCCUR r i-1 EACH OCCURRENCE S OLCESS M'}M C_ WMBAWSE_ AGGREGATE. S IRElENT10N1 S WORKERS OOMPEMTION WCSTATV '� .OTH AIO9PLOYERO'LIABILnT YIN TORY LIMBS, ER, ANY PROMiiETORMARTNEREXECURvE NIM,II r EL EACH ACCIDENT S O"KAMIEMSEREXCLUDEDt pWn4Mry M m) 'II E L DISEASE - EA EMPLOYEE S e MI.WUb uMN ' E L DISEASE - PULH:Y uMrt { FF DESCRIPTION OF OPERATIONS I LOCATIONS IVENKLES IRRxAACORDT01,A40ISNNMR~BSCIIa4.RMMSpR NIe""OI Certificate holder has been added as additional insured regarding the above mentioned polky per attached Additional Insured - Designated Person or Organization (CG20 26, ED. 04 13) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City, Its City Council, Its officers, officials, employees, agents and THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Volunteers ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE 4D1988.2014 ACORD CC ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS0251mL01I .v1"_v.,�c RMrMMssBLmMntDMlbn REVIEWID&APPROVED BY: MOWER Rhk Management Speargist