OROZCO, LISANDRO - Laserfiche WebLink

Home Browse Search

DATE(MM/DD/YYYY) '4 �® CERTIFICATE OF LIABILITY INSURANCE 03/24l2026 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: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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(s). PRODUCER CONTACT NAME: Pr ressive Advantage Business Program Progressive Advantage Business Program PHONE FAX PO Box 5316 (A/C,No,EXt: 844 306-4926 A/c No): Binghamton NY 13902 E-MAIL ADDRESS: commercialservice homesite.com INSURERS AFFORDING COVERAGE NAIC# INSURERA: Midvale Indemnity Company 27138 INSURED INSURER B: Lisandro Orozco DBA Santa Ana History 333 E 9th St Unit 403 INSURER c Santa Ana CA 92701 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:00003242902566 REVISION NUMBER: HIS 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 UCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF ADDL SUER POLICY EFF POLICY EXP LIMITS LTR INSURANCE INSR WVD POLICY NUMBER MM/DD:'YYYY1 MMIDD/YYYY A COMMERCIAL GENERAL LIABILITY P00194096 03/20/2026 0312012027 EACH OCCURRENCE $1.000,000 CLAIMS- DAMAGE TO RENTED MADE OCCUR PREMISES(Ea occurrence) $100.000 MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1 OOD 000 GENT AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE -P000,000 g POLICY F—IJEO- �OC PRODUCTS-COMP/OPAGG $2.000,000 OTHER: UTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) OWNED AUTOS ONLY SCHEDULED AUTOS BODILY INJURY(Per accident) HIRED AUTOS NON-OWNED PROPERTY DAMAGE ONLY [7� AUTOS ONLY iPeraccidenti UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS-MADE ,GGREGATE DED RETENTION$ ORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE I I ER ANY PROPRIETORIPARTNERIEXECU -TIVE OFFICERIMEMBER EXCLUDED? NIA E.L.EACH ACCIDENT (Mandatory In NH) E.L.DISEASE-EA If yes,describe under E.L.DISEASE-POLICY LIMIT .DESCRIPTION OF OPERATIONS below PROFESSIONAL LIABILITY OCCURRENCE AGGREGATE DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Photographers-CITY OF SANTA ANA Its City Council,officers,officials,and agents are an additional Insured on the general liability policy for work/service performed by the named Insured on a PrImaEX and Non-Contributory basis.Waiver of Subrogation applies CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN CITY OF SANTA ANA ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA AUTHORIZED REPRESENTATIVE SANTA ANA CA 92701 APPROVED By Tu Tran Nguyen at 11:39 am,Mar 26,2026 ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD