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CERTIFICATE 4F LIABILITY INSURANCE DATE(MM1DDNYYY)
<br /> ilh � 12/24/2024
<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 /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br /> this certificate does not confer rights to the certificate holder in lieu of such endorsements .
<br /> PRODUCER CONTACT Ben Goode
<br /> NAME:
<br /> StateFarm State Farm Insurance and Financial Services PHONE (951)501-1000c NQ: (951}501-1001
<br /> Agent,Bon Goode E-MAIL ben@goodeagent.com
<br /> 41880 Kalmia Street,SUlte 125 INSURER 5 AFFORDING COVERAGE NAIL If
<br /> Murrieta CA 92562 INSURER A: State Farm Fire and Casualty Company 25143
<br /> INSURED INSURER B r State Farm Mutual Automobile Insurance Company 25178
<br /> Santolucito Dore Group, Inc' INSURER C:
<br /> 31600 Railroad Canyon Road,Suite 100-L INSURER D:
<br /> INSURER E:
<br /> Canyon Lake CA 92587 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE PlhlQn min.DDL SUBR POLICY NUMBER MM DDIYYYY EFF MMIUD�YIYI'xYY LIMITS
<br /> COMMERCIAL GENERAL LIABILITY
<br /> EACH OCCURRENCE $ 1,000,000
<br /> D
<br /> AMAGE TO RENTED 500,000
<br /> CLAIMS-MADE OCCUR PREMISES Ea occurrence $
<br /> MED EXP(Any one person) $ 5,000
<br /> A Y Y 92-ES-R3814 0110112025 0110112026 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY PRO- ❑ LOG 2,000,000
<br /> JECT PRODUCTS-CDMPlOPAGG $
<br /> OTHER' $
<br /> AUTOMOBILE LIABILITY Y Y 7301128-AO1-75H 01/01/2025 07/0112025 COM1Icde°t$INGLELIMIT $ 2,000,000
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> B OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> $
<br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAR HCLAIMS-MAOF AGGREGATE $
<br /> DED I I RETENTIONS I $
<br /> WORKERS COMPENSATION PER I OTH
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE I ER
<br /> A ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICERIMEMBER EXCLUDED? � NIA Y 92-TA-M678-6 01/12/2025 01/1212026
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under
<br /> DESCRfPT10N OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1-000,000
<br /> Commercial Liability Umbrella Policy
<br /> A Y 92-J7-C947-7 01i0112025 01/01/2026 Each Occurrence 1,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more space Is required(
<br /> City of Santa Ana,officers,agents,employees,and volunteers are named a additionally insured on this policy pursuant to written contract,agreement,or
<br /> memorandum of understanding.Such insurance as is afforded by this policy shall be primary,and any insurance carried by City shall be excess and non
<br /> contributory.
<br /> APPROVED
<br /> By Cynthia Mora at 12:91 pm, Jan 09, 2025
<br /> CERTIFICATE HOLDER CANCEL
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Risk Management Division
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92702
<br /> @ 1988-2015 AC MD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> 1001486 132849,12 03-16-2016
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