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i� INLAMOV-02 NCHU <br />AFRO CERTIFICATE OF LIABILITY INSURANCE O s/Allv7.0 AYYv) <br />1I <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), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <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 />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER License # 0757776 1 g9HPCT Gail Schrenk <br />INSURED <br />)nal Insurance Services Inc. <br />92517 All <br />Inland Moving & Storage, Inc. <br />dba: Burgess Moving and Storage <br />P.O. Box 28 <br />Riverside, CA 92502 <br />COVFRAGFS <br />231-2572 <br />THIS IS TO CERTIFY THAT THE POLICE S E E UED G II� U�Fy� ABO E TIE Rift" PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION .F ANY C INT l Y BF1�D0 WI Ir TE HICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AF'JRf :D BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY AV'. BEEN REDUCED BY PAID CLAIMS. <br />INSR TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF POLICY EXPJJR. LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE �X OCCUR <br />X <br />X <br />TCP011035720 <br />4/112024 <br />411/2025 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMAGETORENrED <br />PREMISES We occumencel <br />100,000 <br />$ <br />X <br />Ded $lk each claim <br />VIED EXP (Any one persan <br />5,000 <br />PERSONAL&ADV INJURY <br />It 1,000,000 <br />GENT <br />AGGREGATE LIMpN� APPLIES PER: <br />POLICY JECT LOC <br />GENERALAGGREGATE <br />2,000,000 <br />PRODUCTS - COMP/OP AGG <br />2,000,000 <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMN <br />Me acriden <br />1,000,00 g <br />BODILY INJURY Per erson <br />ANY AUTO <br />OWNED X SCHEDULED <br />AUTOS ONLY AU�T.JOpByyry <br />X <br />TCP011035720 <br />4Y112024 <br />4/112025 <br />BO�DILY INJURY Per accident <br />X <br />X <br />AUTOS ONLY X AUTOS ONLY <br />Liability Ded.$1k <br />Pe�acadent AMAGE <br />$ <br />is <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />H <br />AGGREGATE <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOWPARTNERr ECUTIVE ❑ <br />QQF�FI aey,MeEZEXCLUDED? <br />(Mantlatory In NH) <br />If yes, describe under <br />NIA <br />I PER OTH- <br />E.L. EACH ACCIDENT <br />E.L. DISEASE - EA EMPLOYE <br />DESCRIPTION OF OPERATIONS below <br />EL. DISEASE - POLICY LIMB <br />A <br />Cargo Liability <br />TCP011035720 <br />4/1/2024 <br />411/2025 <br />Any One Loss <br />100,000 <br />A <br />Cargo Liab. DED: $1 K <br />TCP011035720 <br />4/1/2024 <br />41112025 <br />Aggregate In Transit <br />200,000 <br />DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Main Insured Location: 1625 Iowa Ave Riverside CA 92507 <br />Revised 04/04/2024 - This certificate rescinds and supersedes any and all prior certificates Issued on behalf of the Named Insured. <br />City of Santa Ana, officers, agents, employees, representatives and volunteers are Additional Insured with regard to General Liability when required by written <br />contract per the attached endorsement form 064058 04118. Primary & Non -Contributory wording applies With regard to General Liability when required by <br />written contract per the attached endorsement form CG2001 04113. Waiver of Subrogation with regard to General Liability applies when required by written <br />contract per the attached endorsement form CG2404 05/09. Additional Insured with regard to Auto Liability when required by written contract per the attached <br />SEE ATTACHED ACORD 101 <br />SHOULD ANY OF THE ABOVE DESCF <br />City of Santa Ana THE EXPIRATION DATE THERE( <br />Risk Management Division ACCORDANCE WITH THE POLICY PR <br />20 Civic Center plan <br />Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE <br />a4m _. <br />ACORD 25 (2016103) ©1988.2015 ACORD <br />The ACORD name and logo are registered marks Of ACORD <br />sets manr8anvl[ IJMten <br />REVIEWED & APPROVED BY: <br />A-lu "44 <br />®' Rek Management Specialist <br />