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PolicV Number: CATO 208444 <br />Date Entered: 10/31/2013 <br />!�I ® CERTIFICATE OF LIABILITY INSURANCE <br />DAE,MMI °D Y) <br />1/13/2014 <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 tha cBrtificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the term's 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 Ileu of such endorsoment(s). <br />PROOUCH0. Interstate Trans IasuranOe Broker Inc, <br />P.4.BOX 911094 <br />Commerce, Ca 90091 323 -725 -0003 <br />OONTACT <br />SAM <br />PNONE <br />C <br />son. (323) 728-0003 =, o. (32_3_ ) 8BHw2331 <br />EMAIL <br />D <br />FSS: itib20000aol. core <br />INSURERJS L1 AFFORDING COVERAGE <br />_.._. . _._ ....................._... ._._.....-........._..- ... -_... <br />NAICb <br />INSURER A:Rt31n StJECla1t] IR9l1Y8Y1Ce GOlppeny <br />1171b9 <br />INSURED TranspOrtes Intercal.i£orcias. Inc, <br />INSURER B, Coomarcial A111.ar1Ce :Ca$=Cnce CC <br />1090E <br />INSURERat <br />MR RICHARD GOMEZ <br />4/25/2013 <br />4/25/2016 <br />5013 TELEGRAPH RD <br />INSURER D: <br />NED EXP EAre one person) <br />INSURER E: <br />PERSONAL BABY INJURY <br />LOS ANGELES, CA 90022 <br />INSURER F: <br />_ <br />nG aYIGICeTE i B 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 WIYH 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 POUMES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />TOR <br />LTR <br />OF INSURANCE <br />R <br />WV <br />POLICYNUMBER <br />MMI YY <br />MMU)ID I <br />LIMITS <br />GENF.RAt,UABfGTY <br />EACH OCCURRENCE <br />$1,000,000.00 <br />A <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS•MAbn z OCCUR <br />X <br />CI8174327 <br />4/25/2013 <br />4/25/2016 <br />w <br />$ 100,000.00 <br />NED EXP EAre one person) <br />$ 5,000.00 <br />PERSONAL BABY INJURY <br />$ <br />GENERAL AGGREGATE <br />$2,000,000.00 <br />GEML.AGGREGATE <br />LIMR'APPLIES <br />PER: <br />PRODUCTS- COMP /DPAGG <br />S <br />$ <br />POLICY <br />gg,?i <br />El <br />LOC <br />H <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />ALL TOS OWNER AUTOSVL80 <br />HIRED AUYOS NON-OWNED <br />/ <br />X <br />LAIC 208444 <br />0/30/2013 <br />0/30/2014 <br />EL <br />eeamdanl <br />9'0()0'()00.00 <br />_ <br />BODILYINdURY(Perpetson) <br />S <br />O <br />BODILY INJURY (Pe: amdeRi) <br />S <br />$ <br />RAMAG <br />4d <br />$ <br />S <br />UMBRELLALIAB <br />OCCUR <br />FACH CCCURR&NCR <br />$ <br />AGGREGATE <br />S <br />EXCESS LIPS <br />CLAIMS -MADE <br />DEC I I RETENTION $ <br />5 <br />WOkkERS COMPENSATION <br />AND EMPLOYERS LIABILITY <br />ANY FROPRIETORIPARTNERIF ,XECUTIVE Y/❑N <br />OFFICERIMEMBER EXCLUDED? <br />IMyyendatory III NH) <br />NIA <br />VJCSTATU• . 0TH• <br />E.L. EACH ACCIDENT <br />$ <br />E,1- DISEASE -EA EN,PL• Y <br />$ <br />E.1. SIB no, PO I Lda11T <br />$ <br />ID E9GIRAPTION OF OOPERATIONGbele'v <br />DESCRIPTION OF OPERATiONSf LOCATIONSIVEHICLE51 Ateich ATAR0101, Additional Remerks Sdredele, If mere apace is requiradl -�_ p,0dy <br />Owssors, Landlnrs and Tenants Coverage. -'" SLL Sh <br />* * *CertiPic2te holder is named as additional insured * ** la& l cjty NYtOAT \C`i <br />Parki.ng rae3.lity Por: Transportes Interaalifornias Inc 'xSS1.stItVIA <br />CITY OF SANTA ANA PUBLIC WORKS AGENCY <br />SANTA ANA REGIONAL TRANSPORTATION CENTER <br />1000 E. SANTT ANA BLVD. SUITE 106 <br />SANTA ANA, CA 92701 <br />rAX- 719 -555 -2692 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 8EFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WHITE THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />3AN K ITTB INCc C <br />(01988-2010 <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />Produced using Forms Boss Plus solpvare, MwN.FarmeBuss,cnm; Impressive Publishing 80020 &1917 <br />