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..4toconiff CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) <br /> 06/22/2023 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br /> THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE <br /> POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), <br /> AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, <br /> subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not <br /> confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> DANIELS HEAD INS AGENCY INC/PHS NAME: <br /> 65813296 PHONE (866)467-8730 FAX <br /> (A/C,No,Ext): (AIC,No): <br /> The Hartford Business Service Center <br /> 3600 Wiseman Blvd E-MNL <br /> San Antonio,TX 78251 ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAICY <br /> INSURED INSURERA: Sentinel Insurance Company Ltd. 11000 <br /> PALACIOS LAW OFFICE INSURER B: <br /> PO BOX 7282 <br /> RIVERSIDE CA 92513-7282 INSURER C: <br /> INSURER D: <br /> INSURER E: <br /> INSURER 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.NOTWTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VYHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br /> TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> LTR INSR WVD IMM/DD/YYYYI IMM/DD/Y YYYI <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br /> CLAIMS-MADE X OCCUR DAMAGE TO RENTED $1,000,000 <br /> PREMISES fEa occurrence) <br /> x General Liability MED EXP(Any one person) $10,000 <br /> A X X 65 SBM TH3424 06/28/2023 06/28/2024 PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> POLICY PRO' It LOC PRODUCTS-COMP/OP AGG $2,000,000 <br /> JECT <br /> OTHER: <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) <br /> ALLOVUNED —SCHEDULED <br /> A AUTOS AUTOS 65 SBM TH3424 06/28/2023 06/28/2024 BODILY INJURY(Per accident) <br /> _ <br /> HIRED NON-OWNED PROPERTY DAMAGE <br /> X AUTOS X AUTOS (Per accident) <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE <br /> EXCESS LIAB CLAIMS- <br /> MADE AGGREGATE <br /> DED RETENTION$ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY STATUTE ER <br /> ANY YIN E.L.EACH ACCIDENT <br /> PROPRIETOR/PARTNER/EXECUTIVE — N/A <br /> OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE <br /> (Mandatory in NH) <br /> If yes,describe under E.L.DISEASE-POLICY LIMIT <br /> DESCRIPTION OF OPERATIONS below <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) <br /> Those usual to the Insured's Operations.Certificate holder is an additional insured per the Business Liability Coverage Form 550008 attached to this <br /> policy.Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form 550008,attached to this policy. <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> Risk Management Division BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED <br /> 20 CIVIC CENTER PLZ IN ACCORDANCE WITH THE POLICY PROVISIONS. <br /> SANTA ANA CA 92701-4058 AUTHORIZED REPRESENTATIVE <br /> Rlek Manlygemmt Dlvielon <br /> 'aean of /1 .mac.. iPet. REVIEWED&Asmoveo BY: <br /> ©1988-2015 ACORD COI IN~ e`! Aild <br /> AddM m. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Risk Management specialist <br /> Aga. xw i ,q-i. s . .!:!It „ ,:,, <br />