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Aco 0 <br /> CERTIFICATE OF PROPERTY INSURANCE 9123/M'DD'YY"Y' <br /> 9/23/2024 <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 /> PRODUCER CONTACT <br /> NAME: <br /> Hiscox Inc.diblal Hiscox Insurance Agency in CA PHONE g44-357-0403 FAX <br /> 5 Concourse Parkway Arc No): <br /> E-MAIL <br /> Suite 2150 ADDRESS: r-ontact@hiscox.com <br /> Atlanta GA,3032B PRODUCER <br /> CUSTOM ER ID <br /> I Angie Ac ve <br /> INSUREDl'-% Hjcrn t 00 <br /> Nastich Law,a Professional Corporation INSURER B: <br /> 2341 Derby Street <br /> Berkeley,CA 94705 INSURER C: <br /> INSURER D: <br /> INSURER E: <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> LOCATION OF PREMISES I DESCRIPTION OF PROPERTY (Attach ACORD 101,Additional Remarks Schedule,it more space is required) <br /> 2341 Derby Street,Berkeley,CA 94705 <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. 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 POLICIES 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 /> INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION COVERED PROPERTY LIMITS <br /> LTR DATE(MM1DDfYYYY) DATE(MMIDD/YYYY) <br /> X PROPERTY BUILDING <br /> $ <br /> CAUSES OF LOSS DEDUCTIBLES X PERSONAL PROPERTY <br /> $ $ 10,000 <br /> BASIC BUILDING X BUSINESS INCOME $. <br /> BROAD CONTENTS P103.767.918.1 09/0712024 09/07/2025 X EXTRA EXPENSE $ <br /> A X SPECIAL $500 RENTAL VALUE $ <br /> EARTHQUAKE BLANKET BUILDING <br /> WIND BLANKET PERS PROP <br /> FLOOD BLANKET BLDG&PP <br /> $ <br /> INLAND MARINE TYPE OF POLICY $ <br /> CAUSES OF LOSS <br /> NAMED PERILS POLICY NUMBER $ <br /> CRIME <br /> TYPE OF POLICY $ <br /> $ <br /> BOILER&MACHINERY 1 $ <br /> EQUIPMENT BREAKDOWN <br /> $ <br /> SPECIAL CONDITIONS I OTHER COVERAGES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> RE:Administrative Hearing Officers(24-052) <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Santa Ana <br /> 20 Civic Center Plaza,M-17 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Santa Ana,CA 92701 THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PRC <br /> w, a FJskMatmgemalEDMsIon <br /> AUTHORIZED REPRESENTATIVE W <br /> IREmmim&APPROVE)ft <br /> Risk Management Specialist <br /> O 1995-2015 ACORD <br /> ACORD 24(2016/03) The ACORD name and logo are registered marks of ACORD <br />