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ACOR" CERTIFICATE OF LIABILITY INSURANCE FDATEIMMIDDIYYYY) III06/04/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Aidee Lopez StateFarm Aidee Lopez Insurance Agency Inc HO No Ext, 714 775 309Q arc No 1415 S Broadway St E-MAIL Santa Ana CA 927D7 INSURER($)AFFORDING COVERAGE NAIL# INSURER A: State Farm Fire and Casualty Company 25143 INSURED INSURER B: Relampago De Cielo,Inc INSURER C; Pp Box 3158 INSURER D: Q E� Santa Ana CA 92703 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN SR ADD SUB POLICY E P LI UY E X P TYPE OF INSURANCE LTR INSD WVD POLICY NUMBER MMIODIYYYY) 1MM/DDfYYYYJ LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE El OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ACV INJURY $ GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ PRO- POLICY F7 JECT F7 LOD PRODUCTS-COMPOEAGG $ OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) S HIRED NON-OWNED AUTOS ONLY AUTOS ONLY Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEO I I RETENTION S $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY $ ANY PROPRIETORIPARTNERfEXECUTIVE Y r N E.L.EACH ACCIDENT $ 1,QOQ,QDQ X OFFICERIMEMSER EXCLUDED? ❑ NIA 92-TA-JB73-6 09/15/2024 09/15/2025 {Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below I I I I E.L.DISEASE-POLICY LIMIT $ 11000,000 DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may 6e attached if more space Is required) 600 W SANTA ANA BLVD,SANTA ANA,CA 92701;City of Santa Ana,its City Council,its officers, officials,employees,agents,and volunteers are to be covered as additional insureds with respect to liability arising out of work or operations performed by or on behalf of the instructor including materials,parts, equipment,and personnel furnished in connection with such work or operations.Waiver of Subrogation applies,Location:Centennial Park-City of Santa Ana, 3000 W Edinger Ave.,Santa Ana,CA 92704,Concert In The Park. APPROVED CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 7:23 am,Jul 02, 2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana,Attention:Executive Director,Community ACCORDANCE WITH THE POLICY PROVISIONS. Development Agency,20 Civic Center P#aza M-25,Santa Ana, AUTHORIZED REPRESENTATIVE CA 92701 Completed by an authorized State Farm representative.If signature is required, please contact a State Farm agent. rJ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 1001486 132849.14 04-13-2022