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.Ac-vR" CERTIFICATE OF LIABILITY INSURANCE r
<br /> ATE(MM1DDfYYYYI
<br /> 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 NAME: Ben Goode
<br /> StateFarm state Farm Insurance and Financial Services PHONE (951)501-1000 FAX No: (951)501-1001
<br /> Agent,Ben Goode E-MA Lss: ben@goodeagent.com
<br /> i •
<br /> 41880 Kalmia Street,Suite 125 INSURERS AFFORDING COVERAGE NAIC If
<br /> Murrieta CA 92562 INSURER A: State Farm Fire and Casualty Company 25143
<br /> INSURED INSURER B: State Farm Mutual Automobile Insurance Company 25178
<br /> Santolucito Dore Group,Inc. INSURER C:
<br /> 31600 Railroad Canyon Road,Suite 100-L INSURERD:
<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 /> CERTIFICATF 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 INSD_W D_ POLICY NUMBER MM ABfYYYY MCY FFF MlDD[YYYYY LIMITS
<br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> D
<br /> CLAIMS-MADE AMA
<br /> accuR PREMISESGE TO RENTED
<br /> Ea occurrence $ 500,000
<br /> MED EXP(Any one person) $ 5,000
<br /> A Y Y 92-ES-R381-4 01/01/2025 0110112026 PERSONAL&ADV INJURY $ 1,000,000
<br /> GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000
<br /> POLICY PRO- LOC PRODUCTS-COMPIOPAGG $ 2,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY Y Y 730 1128-A01-75H 01/01/2025 07/01/2025 (Fa BINEDISINGLE LIMIT $ 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 /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB Ll CLAIMS-MADE AGGREGATE $
<br /> DED I I RETENTION$ $
<br /> WORKERS COMPENSATION PER OH_
<br /> AND EMPLOYERS'LIABILITY Y f N STATUTE I I ER
<br /> ANY PROPRIETORIPARTNERfEXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> A OFFICERIMEM13ER EXCLUDED? Y� N f A Y 92-TA-M678-6 01112/2025 01/12/2026
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000.000
<br /> Commercial Liability Umbrella Policy
<br /> A Y 92-J7-C947-7 0110112025 01I0112026 Each Occurrence 1,000,000
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If 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 12:11 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 h,ohew
<br /> O 1988-2015 ACOMD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> 1001486 132849.12 03-1C 2D16
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