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DATE(MMIDDIYYYY) <br /> ,d►c�crzrl CERTIFICATE OF LIABILITY INSURANCE 07/08/2024 <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 /> MEDPRO INSURANCE SERVICES LLC/PHS NAME: <br /> PHONE (866)467-8730 FAX <br /> 36214543 (A/C,No): <br /> (A/C,No,Exo: <br /> The Hartford Business Service Center <br /> 3600 Wiseman Blvd ngie <br /> E-MAIL • . •San Antonio,TX 78251ADDRESS: _ n IN ) COV G NAIC# <br /> INSURED INSURERA: enflnell uranceCosnpany d. 1.00 <br /> PALACIOS LAW OFFICE INSURERS oy Angie X-cevedo <br /> PO BOX 7282 <br /> RIVERSIDE CA 92513-7282 INSURER <br /> RF� Date: 2024.07. 12 <br /> ilk <br /> COVERAGES CERTIFICATE NUMBER: _ • REV! I • NU r W V <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTEF BEI iW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR C I.,JDITION 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 <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 (MMIDD/YYYY) (MM/DDIYYYY) <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br /> CLAIMS-MADE X OCCUR DAMAGE TO RENTED $1,000,000 <br /> PREMISES(Ea occurrence) <br /> x General Liability MED EXP An( y one person) <br /> ) $10,000 <br /> A X X 36 SBM TH3424 06/28/2024 06/28/2025 PERSONAL BADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> POLICY PRO- X LOC PRODUCTS-COMP/OP AGG $2,000,000 <br /> JECT <br /> OTHER: <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) <br /> A ALL OWNED SCHEDULED 36 SBM TH3424 06/28/2024 06/28/2025 BODILY INJURY(Per accident) <br /> AUTOS AUTOS— <br /> HIRED NON-OWNED PROPERTY DAMAGE <br /> X AUTOS X AUTOS (Per accident) <br /> _ UMBRELLA LIAB OCCUR EACH OCCURRENCE <br /> EXCESS LIAB — CLAIMS- <br /> MADE AGGREGATE <br /> IDED RETENTION$ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY STATUTE ER <br /> ANY Y/N E.L.EACH ACCIDENT <br /> PROPRIETOR/PARTNER/EXECUTIVE NI 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 SS0008 attached to this <br /> policy.Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SS0008,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 /> (' Q ys RlekMetagernentDivision <br /> CJ �)c' L�L P�itiCL �'' LIN REVIEWED&APPROVED BY: <br /> ©1988-2015 ACORD COf �' A a AteveO <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ® Rbk Management Specialist <br />