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2- <br />[�T <br />0 �E <br />M* <br />A6��Zo CERTIFICATE OF LIABILITY INSURANCE 9Y'221'2 <br />T11 <br />I <br />mW <br />lillAMENg W Z ag1w, sic 19 w4m,104711 MAP 144" <br />NO <br />=1411W oil <br />'__W_P0RTA1Nt� Fif th-ei—c—ortIficate -I o Id- eir"Isi'an"Ab IDITIONAL INSURED, the policy(les) must be endors( <br />t�he terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />e <br />R <br />certificatholder In lieu of such endorsoment(s). ---- --- <br />R <br />I Steve Fiorentino 'O"D"U C E NA E, <br />Steve Fiorent�ino Insurance Agency Inc. <br />PHONE 650-322-3499 k50-323-8231 <br />Ste!ve Ficrentino, Agent INC,, <br />EbMAIL <br />StateFarn? _A RESS_SteVeflorqLtno.cgs4@statefann.com <br />1182 Chestnut Street <br />Menlo Park, CA 94025 <br />INSURER A � State Farm General Insurance Company <br />INSURED DonaId H Maynor Attorney INSURER B:State Farm Mutual Autorriobfle Insurance, Ccmp�jn <br />A Professional Corporation <br />235 Catalpa Drive 'N"BRIERIk" <br />Atherton, CA 94027 1 INSURER E; -- ----- <br />COVERAGES CERTIFICATE NUMBER: REVISION NUM ER:: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PFR765 <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 POUCIE�S 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 />;U8R CY EXP <br />LTR'TYPE OF WSURANCE Isso WVD POUCYNUMLIER faIMIDUYyyyl (MM1Dwy)ffyj LIMITS <br />A X COMMERCIAL GENERAL LIABILITY EACH OCCORRENCE 1,000,000 <br />In rDrIlr <br />300, <br />CLAIMS -MADE F _V1 OCCUR <br />.. ... ....... <br />, <br />97-CF1003-3 G 1011612015 101161 000 <br />2016 M'EO'E'X_P('A'ny­ona prre'rs'an)$ 5 000 <br />$ <br />-- <br />2,000,000 <br />.9E,NT AGGREGATE UMIT APPUES PER: GENERAL AGGREGATE S 2,000,000 <br />,000 <br />POLICY LOC 2.000 <br />OTHER� SINGLE UWT — <br />MOBILE <br />B AUTOMOBILE LIABIUTY 1,000,000 <br />ANYAUTO 026 1456 -C19 -0S 0911912015 0311912016 B. OOIILY IN r JU RY (Per p - am - on)-- <br />ALL OWNED SCHEOLHLED BODILY INJURY (Per accident) $ <br />U <br />AUTOS ATOS <br />NON�OWNED YDAMAGE S <br />HIRED ALITOS AUTOS <br />UMBRELLA LIAR <br />'("UR JACH C_C"P.RENCE------- - --- <br />00 <br />EXCESS LIAR CLAW MADE AGGREGATE <br />...... . ..... <br />11,07-1 'RETENTION S $ <br />RKERS COMPENSATION ,_p ON - <br />AND EMPLOYERS'LIAMLITY YIN <br />ANY PROPRIETOR�PARTNEMEXECUTNF r---1 <br />OFFICEMMEMBER EXCLUDEW� NIA .......... . ..... <br />(Mandatm In NH) E. L. 04SEASE - EA EMPLOYEE S <br />H yaae, describe under <br />DC;SCRIPTION OFOPERATIONS below 'E,t DISEASE POLICY LIM� �T $ <br />ERA17NS I LOCAnONS I VEHICLES JACORD 1T1 <br />DESCRIP Additional Remarks Schedule, may be attached If mom space I. ren. <br />ADDITIONAL INSUORED: <br />THE CITY OF SANTA ANA <br />ITS OFFICERS, EMPLOYEES, <br />VOLUNTEERS & REPRESENTATIVES <br />20 CIVIC CENTER PLZ I�X'RSANTA ANA CA 92701-4058t <br />THE CITY OF SANTA ANA N DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ITS OFFICERS, EMPLOYEES, ITH THE POLICY PROVISIONS, <br />V01LUNTEERS & REPRESENTATIVES <br />2�O CIVIC CENTER PLZ <br />SANTA ANA CA 92701-4058 <br />(61988-2014 �CORD CORPORATION. All rights reserved. <br />ACORD,26 (2014101) The ACORD name and logo are registered rnarks of ACO�RD 1001486 1328499 0,2-04-2014 <br />