My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
STANFORD SOUND AND STAGE
Clerk
>
Contracts / Agreements
>
S
>
STANFORD SOUND AND STAGE
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
5/7/2025 9:06:11 AM
Creation date
5/7/2025 9:05:52 AM
Metadata
Fields
Template:
Contracts
Company Name
STANFORD SOUND AND STAGE
Contract #
N-2025-104
Agency
Community Development
Expiration Date
1/12/2026
Insurance Exp Date
5/1/2025
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
16
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
,4`"R o�® CERTIFICATE OF LIABILITY INSURANCE D02i17/20`25"' <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACTELIDA GARCIA CERVANTES <br /> NAME: <br /> Eddie Quillares Jr. State Farm Agency PHONED f.714-617-7150 FAX Ne:714-617-7158 <br /> StateFarm 415 N Broadway nooRESS,ELIDA.GARCIACERVANTES.VAF5S3@STATEFARM.COM <br /> Santa Ana, CA 92701 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURERA:State Farm Fire and Casualty Company 25143 <br /> INSURED Modesto Briseno INSURERB: <br /> DBA Stanford Sound and Stage INSURERC: <br /> 2321 E 4th Street INSURER D: <br /> Santa Ana, CA 92707 INSURERE: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:75-0450 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. 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 -rypE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MMIDDIYYYY MMIDDIYYYY <br /> A X COMMERCIAL GENERAL LIABILITY Y Y 92-KN-B559-0 05/01/2024 05/01/2025 EACH OCCURRENCE S 1,000,000 <br /> CLAIMS-MADE �OCCUR DAMAGE TO RENTED 300,000 <br /> PREMISES Ea occurrence $ <br /> X BUSINESS PROPERTY MED EXP(Any one person) $ 5.000 <br /> PERSONAL&ADV INJURY S 1.000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000.000 <br /> POLICY PRO LOC PRODUCTS-COMPIOP AGG $ 2,000,000 <br /> JECT <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Fa accident <br /> ANY AUTO BODILY INJURY(Per person) S <br /> ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ <br /> NON-OWNED PROPERTY DAMAGE <br /> HIRED AUTOS AUTOS Per accident $ <br /> L $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY YIN STATUTE I I ER <br /> ANY PROPRIETORIPARTNERIEXECUTIVE ElNIA E.L.EACH ACCIDENT $ <br /> OFFICERIMEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) <br /> The City of Santa Ana, its officers, officials, employees, and volunteers are included as Additional Insured on the above referenced <br /> policy where required by written contract.A Waiver of Subrogation applies in favor of the Certificate Holder. Tu Tran yNig dby ruran <br /> Nguyen o5;,07W <br /> Location for All Events: Suavecito Headquarters, 2831 W. 1st Street, Santa Ana, CA 92703 <br /> APPROVED <br /> CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 9:51 am,Apr 23,2025 <br /> City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Attention: Executive Director, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Community Development Agency, ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 20 Civic Center Plaza, M-25 Santa <br /> Ana, CA 92701 AUTHORIZED REPRESENTATIVE <br /> ©1988-2014 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2014 <br />
The URL can be used to link to this page
Your browser does not support the video tag.