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,r 0c"k, (J?r7frr. <br />1 <br />ncoRCb® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) <br />1ft 06/11/2013 <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 CONTACT Fran Thomas NAME: <br />DFI DiGerolamo Family Insurance Services PHONE <br /> (951)735-5335 ac Nn: (951)893-2750 <br />AID No.,Xu. <br />2027 Hamner Ave E- <br />MAIL <br /> ADDRESS: Fran@dfiinsurance.com <br />Norco, CA 92860 <br />" <br />// <br />? <br />. <br />? <br />U' <br />- INSURERS AFFORDING COVERAGE NAICB <br />6J / <br />? <br />License #: OD26889 ? <br />/ <br />fJC <br /> INSURER A: Amercian States Ins. Co. <br />INSURED INSURER B. Century National Insurance <br />PRESTIGE STRIPING SERVICES INC. INSURER C: <br />1054 Railroad St INSURER D: <br />Corona, CA 92882 INSURER E: <br /> INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 00012074.4488788 REVISION NUMBER: 392 <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 <br />LTR TYpE OF INSURANCE ADDLSUSR <br />POLICY NUMBER POLICY EFF I POLICY EXP <br />MMIDDIYYYY' MMIDDIYYVV LIMITS <br />A GENERALLIABILITY Y 01CG76837990 03/22/2013 0312212014 EACH OCCURRENCE $ 1 060000 <br /> X COMMERCIAL GENER <br />AL <br />LIABILITY PREMSES Ea accorre $ 1 000 000 <br /> ? <br />? <br />CLAIMS-MADE til OCCUR MED EXP(Anyone person) $ 10,000 <br /> X CONTRACTUAL _ <br />PERSONAL aADVINJURY _ <br />$ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATELIMIT APPLIES PER PRODUCTS-COMP/OP AGO $ 2,0000,000 <br /> POLICY X PRO- LOC _ S <br /> <br />B AUT OMOBILE LIABILITY <br />Y <br />BAP0173013 1 <br />0412912013 04I29I2014 <br />COMB INEDSINGLE LIMIT Ea accdent i <br />$ 1,000,000 <br /> X ANY AUTO BODILY INJURY (Per person) $ <br /> ALL OWNED <br />AUTOS SCHEDULED <br />AUTOS BODILY INJURY (Per accltlenQ $ <br /> <br /> <br />X <br /> <br />X <br />NON-OWNED <br />PROPERTYDAMAGE _ <br />$ <br /> HIRED AUTOS AUTOS (Per accident <br /> $ <br /> MBRELLA LIAR OCCUR ry <br />` 1, ?- EACH OCCURRENCE $ <br /> <br />EXCESS LIAR ?r <br />?9 <br />' <br />R/ ?t _ <br /> A CLAIMS-MADE H <br />I1 F1 ^" 1/? AGGREGATE $ <br /> _ <br />RETENTION$ <br />DIED $ <br /> WORKERS COMPENSATION K <br />? WC STATU- GTH- <br /> AND EMPLOYERS' LIABILITY S R <br />C O LIM TS <br /> YIN ?ISA e <br /> ECUTIVE? <br />ANY PROPRIETORIPA NIA {C Attorn E.L. EACH ACCIDENT $ <br /> OFFICEWMEMBEER EXCLUDED? <br />(Mandatory In NH) i <br />515tan E.L. DISEASE-EA EMPLOYE $ <br /> If yes, describe under <br /> DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ <br /> l <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />10 DAYS NOTICE WILL BE SENT FOR NON PAYMENT OF PREMIUM. <br />CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED. COVERAGE IS PRIMARY & NON CONTRIBUTORY <br />JOB: VARIOUS JOB LOCATIONS <br />CERTIFICATE HOLDER CANCELLATION <br /> <br />CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ATTN: ROCK GARCIA ACCORDANCE WITH THE POLICY PROVISIONS. <br />305 E <br />4TH STREET <br />SUITE 201 <br />. <br />, <br />SANTA ANA, CA 92701 AUTHORIZE <br />ENTATIV <br /> ( <br />FHT <br />ep <br />@ 1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />Printed by FHT on June 11, 2013 at 12:56PM