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DESMO-1 OP ID; SG <br />-DATE JMMIDWYYYY) <br />CERTIFICATE OF LIABILITY INSURANCE 4702/2015 <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 statemBrit on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(sl- <br />PRODUCERCONTACT <br />John J. Matsock & Assoc. Inc, <br />1750 N Washington Street <br />Naperville, IL 60563 <br />�NAM Steven L. Monteith <br />_Wj_ E. <br />PHONE <br />A_M_NR,..Egt(330-505-7888 <br />E-MAIL <br />Steven L. Monteith <br />-ARDRESS: <br />INSURER A: Travelers Prop Cas CID 25674 <br />INSURED Donna Desmond Associates �NSURER a: of America <br />Phone #310-475-1114 <br />265 South Beverly Glen Blvd. <br />Los Angeles, CA 90024 MNSURBE D., . ...... <br />INSURER E <br />IINSURER F: <br />COVERAGES CFRTIFIr.ATF NI]MRF=R: <br />r%"wi71Vry rquivior-m; <br />THIS 13 TO CERTIFY THAT THE POUCIPS OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE <br />POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT,, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPEc-r 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 />I NSR _A155 —POLICY-ETF� _POUCY EXP <br />TR TYPE OF INSURANCE wVn <br />IN POLICY NUMBER (MMIDDNYYY) (MMIDDIYYYYI LIMITS <br />GENERAL LIABILITY <br />A <br />x ! COMMERCIAL GENERAL LIABILITY <br />x <br />I, <br />680-1 B716605 <br />1210112015 12101/2016 <br />EACH OCCURRENCE <br />1,000,000 <br />AIiAGE To RE <br />--I' 5;�] <br />MAIMS -MADE LA J OCCUR <br />PIiEMI5E5 Ea <br />MED F)�P (Ary ane person} <br />300,000 <br />10,000, <br />A <br />Ind Contractors <br />680-1 B716605 <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GENT AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMPYOP AGG <br />$ 2,000,000 <br />POLICY El 1211i LOC <br />AUYOM0131LE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident) <br />$ <br />A <br />680-1 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />B716605 <br />1210112015 <br />12101/2016 <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />NON -OWNED <br />I N RED AUTOS X AUTOS <br />P-R-(YPE _RTYOAMAZ_�_ <br />$ <br />�x <br />UMBRELLA LIAB <br />OCCUR <br />TILCIA111 <br />-A F OCCLIRR�ENCE. <br />$ <br />EXCESS LIAR <br />MADE <br />AGGREGATE <br />$ <br />0EDE_ 7111ENTiON <br />$ <br />WORKERS COMPENSATION <br />-7- <br />vvc sTATu- i IoTH- <br />AND EMPLOYERS' LIABILITY Y/N <br />E L.. EACH ACCIDENT I ED) E N�� <br />$ <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />OFFICER JMFMHFR EXCLUDED? F <br />/A <br />DISEASE - EA EMPLOYEF. <br />---- <br />$ <br />(Mandatory In NHI <br />yes, describe undef <br />E. L. DISEASE -POLICY LIMIT <br />DESCRIPTION <br />DESCRIPTION OF OPERATIONS below <br />A lProperty <br />Section <br />680-18716605 5 <br />12101/2016 <br />CESCWPTION OF OPERATIONS / LOCATIONS I VEHICLES(Attach ACORD tial, AddItIonal Remarks Schedule, if more space is required) <br />ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY: CITY OF <br />SANTA ANNA,ITS OFFICERS, EMPLOYEES, AGENTS, VOLUTEtRS AND <br />RE PRE SENTATTVRS / /ADDITIONAL INSURED IS PRIMARY AND NON CONTRIBUTORY <br />AGREEMENT NUMBERS A-2011-070; A-2014-038 & A-2015-159//AS REQUIRED BY <br />WRITTEN CONTRACT, CERTIFICATES ARE SUBJECT TO ALL POLICY, TERMS AND CONDITION <br />EUNKE I IEREDJA (PG OF <br />SANTAAN <br />CITY OF SANTA ANA <br />PUBLIC WORKS AGENCY <br />ATTN: JASON GABRIEL <br />20 CIVIC CENTER PLAZA M-36 <br />SANTA ANNA, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATWE <br />P. <br />vI v 00'4U` IU ALUKL) tUKVUKA I NUN. Ali rights reserved, <br />ACID RD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />