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'` CERTIFICATE OF LIABILITY INSURANCE °"0;,5 9ng° <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), AUTHORD:ED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the cerfificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to Me <br />terms and conditions of Me policy, certain policies may require an endorsement A statement on this certificate does not confer rights to Me <br />certificate holder in lieu of such endmsement(s). <br />PRGWGBa <br />csnoMxE ACT Program Support <br />m°NE . (844)-520E991 FN°%c xa: (801)-763-1374 <br />Veracity Insurance Solutions, LLC. <br />AooREss: C4 into actinsuree. nccom <br />260 South 2500 West, Suite 303 <br />Pleasant Grove UT 84062 <br />IxsMrexts AFFOROMG covERAGe <br />NAKR <br />NsuRmA: Great American Alliance Insurance Company <br />26832 <br />WSVRW <br />INSURER a: <br />Emmy Lam <br />NsuRER c: <br />IXsums, n: <br />1465 Tamarind Ave. #565 <br />Los Angeles CA 90028 <br />INSURER E: <br />IxsuRER F: <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 />ILTR <br />TYPEOFWTURANCE <br />AWL <br />suuR <br />POUCYNUMBER <br />wOCVEFF QYYYYI <br />MMNCYFSP DRYOO <br />Laos <br />GBIERALWBILRY <br />EACH OCCURRENCE <br />s 1.000,000 <br />X COMMERCNL GENERAL LIPBILITV <br />GIAIMSMAOE O OCCUR <br />r� <br />I ^ <br />pREMISEG bvmmnm <br />5 300,000 <br />MEDSP —Inn n) <br />5 5,000 <br />A <br />PLE957546-AS287611 <br />05/22/2024 <br />05/24/2024 <br />PPRSONALaA➢VINJURY <br />5 EXCLUDED <br />GeIERALAGGREGATE <br />s 2,000,000 <br />GENL AGGREGATE LIMIT APRIES PEA: <br />PRODUCTS-GOMPgP AGO <br />S EXCLUDED <br />x PONCY I PR0. I LDC <br />Mflfl L BAILEE <br />5 <br />AMINAIIILE.Iniv <br />r <br />F— <br />CMBINMl <br />CIXAdINF➢SIN L <br />5 <br />BODILY INJUAYLPmp—) <br />—AUnO <br />$ <br />AU OWNFfI BCHEOUIEII <br />AUTOS AUTOS <br />BODILY INJURY me <br />5 <br />NIREOnpS N.—EO <br />AUAUmS <br />PR�FRIY pNAAfE <br />e<m <br />y <br />s <br />mlenELWLMB <br />O:OUR <br />F— <br />F— <br />EACH OCCURRENCE <br />s <br />AGGREGATE <br />5 <br />IXCER Use <br />I <br />I CIAIMSt E <br />DED1 I RETFMIONS <br />.s <br />NbRIrsRS onla'. ATWN <br />YILSTAiV- 'OTH- <br />ER <br />ANGEMPLOYERS-LJABILRYJX Y <br />pNYPROPRIETOWPARINERIEXECVINE <br />I� <br />EI EACHACCICENn <br />5 <br />OFFICEMaMBERE%CLUDEO ❑ <br />NIA <br />El O49EASE-FA EM1IPLOYE S <br />(MUWalory In en <br />__..... <br />E.L.OREASE-P0.ICV LIMIT 5 <br />r <br />F- <br />UESCMMONMOPEMnOMILWATCNSIVEHICLES IA hACORDIGI.A4dMoml RemaAss ule,IlmmsparslsmgW I <br />Certificate holder has been added as additional insured regaling the above mentioned policy per attached <br />Additional Insured - Designated Person or Organization (CG20 26, ED. 04 13) <br />CERTIFICATE HOLDER CANCELLATION <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 <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />AUMORM REPRESMMA <br />019118-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (201N01) The ACORD name and logo are registered marks of ACORD <br />INS025 On,.q <br />,,. <br />RMLM.%v cdDividon <br />REY,EwED6 APPRIT/H)BY: <br />A+� r4ewedD <br />® <br />Rbk Management Spe.Aut <br />