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AC�� DATE IMMIDDffYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE F03I2712025 <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 CO CT <br /> NTA Keir Jones <br /> StateFarm Keir Jones arc No EXt: 5fi2433-5573 FAX Ne: <br /> 5150 E.Colorado Street a-MAIL DRESS. keir.jones.ug42@statefarm.com <br /> INSURER(S)AFFORDING COVERAGE NAIL# <br /> Long Beach CA 90814 INSURER A: State Farm General Insurance Company 25151 <br /> INSURED <br /> INSURER B <br /> THE FRIDA CINEMA INSURERC: <br /> 305 E 4TH ST STE 100 INSURER D: <br /> INSURER E: <br /> SANTA ANA CA 927014639 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 ADD SUB POLICY EFF POLICY EXP <br /> TYPE OF INSURANCE W POLICY NUMBER <br /> LTR INSD VD MMIDDIYYYY MMIDOIYYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 <br /> DAMAGE TO RENTED <br /> CLAIMS-MADE X OCCUR PREMI E a occurrence S 300,000 <br /> MEO EXP(Any one person) $ 10,000 <br /> A Y Y 92-E6-S488-3 12108/2024 12/08/2025 PERSONAL&ADVINJURY s 2,000,000 <br /> GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 4,000,000 <br /> PRO- <br /> POL#CY X <br /> JECT LOC PRODUCTS-COMPIOPAGO s 4,000,000 <br /> OTHER s <br /> COMBINED SINGLE LIMIT <br /> AUTOMOBILE LIABILITY Fa accident $ <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS BODILY INJURY(Par accident) S <br /> HIRED NON-OWNED <br /> AUTOS ONLY AUTOS ONLY Per accident S <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> DED RETENTION $ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY $ <br /> ANY PROPRIETORIPARTNERIEX.ECUTIVE Y I N <br /> OFFICERWEMBER EXCLUDED? N!A E.L.EACH ACCIDENT $ <br /> (Mandatory in NH) EL DISEASE-EA EMPLOYEE s <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> ❑i i 1t,,i—d by <br /> DESCRIPTION OF OPERATIONS)LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) oate:2°as,°sau <br /> ADDITIONAL INSUREDNVAIVER OF SUBROGATION: N U)lEI1's:'°:$�-°'°° <br /> CITY OF SANTA ANA, ITS CITY COUNCIL,OFFICERS, <br /> OFFICIALS,EMPLOYEES,AGENTS AND VOLUTEERS <br /> 20 CIVIC CENTER PLZ FL 4TH <br /> SANTA ANA CA 92701 4058 APPROVED <br /> By Tu Tran Nguyen at 3:10 pm, May 30,2025 <br /> CERTIFICATE HOLDER CANCELLATION <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 PRCSA ACCORDANCE WITH THE POLICY PROVISIONS. <br /> ATTN:PATRICIA MARTINEZ <br /> 20 CIVIC CENTER PLAZA,M23 AUTHORIZED REPRESENTATIVE <br /> SANTA ANA CA 92701 ��Q` — This form was system-generated on 03/27/2025 <br /> OO 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br /> 1001486 2005 15h279 205 01-19-2023 <br />