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DESMOA Op Inr SC <br />16- c ' CERTIFICATE OF LIABILITY INSURANCE <br />DATE 1/151201 YY) <br />11/1512017 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDIER. THIS <br />CERTIFICATE DOES NOT AF'F'IRMATIVELY 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 I$ an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder In lieu of such endorsement(s). <br />John J Matsock& Assoc. Inc. <br />1760NWashingtonStreet <br />Naperville, IL 60663DPD <br />Steven L. Monteith <br />A Steven L. Monteith <br />B ;630-505.7888 c <br />ss. <br />INSURER AFFORDINP COVERAO. 9 NAIL # <br />A <br />A <br />INSURERA:TraveI9jrs;.Prop Cas Co 25674 <br />INSURED Donna Desmond Assoc fates <br />Phone #310-475-1114 <br />265 South Beverly Glen Blvd, <br />INSURER e: of America <br />INPUREB C: <br />INSURER a <br />Los Angeles, CA 90024 <br />INSURER E r <br />R F TO D n a 'ir nce $ 300,00 <br />INSURER F <br />CO <br />THIS IS TO CERTIFY TWAT THE POLICIES O� INSURANCE LISTED BELOW HAVE SEEN ISSUED Tp THE INSURED NAMED A6(?VE FOR TWC 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 7O ALL' THE TERMS, <br />EXCLWSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />1S <br />-TYPt OPINSURANCg <br />BuellCLIP <br />POLICY NUMBER <br />EFP <br />O IQY P <br />LIMIYa <br />A <br />A <br />GENERAL LIABILITY <br />X OMOLAIMIS -MADAL E X AOCCUR <br />X Ind Contractors <br />X <br />6tt0�18716605 <br />660-1B716605 <br />1210912017 <br />12/U112018 <br />EAOH OCCURRENCE $ 1,000,00 <br />R F TO D n a 'ir nce $ 300,00 <br />MED EXp An ale arson) $ 10,00 <br />PERSONAL AADVINJURY $ 1,000100 <br />GENERAL AGGRGATE $ 2,000,00 <br />f�EN'L AGGREGATE I.IMITAPPLIt S PER <br />X1 POLICY ::- LOO <br />PRODUCTS - OMPIOP AGa $ 2+000,00 <br />$ <br />A <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO- <br />ALI. gWNIED SCHEDULED <br />AUTOS AUTOS <br />,HIREDAUTOS X NON -OWNED <br />AUTOS <br />680.1 B716606 <br />1210112017 <br />12/011.2018 <br />CQM EDLE LIMIT <br />Ea amide 1,000,00 <br />BODILY INJURY (Per person) $ <br />BODILY INJURY per accident $ . <br />( � <br />CID $ <br />$ <br />HEXCESS <br />UMBRELLA LJAU <br />LIA13 <br />OCCUR <br />CLAIM$ MAGE <br />EACH OCCURRENCE M <br />AGGREGATE $ <br />"D�D RET NTION <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY I <br />ANY PROPRIETORIPARTNERIEXECUnVU-M <br />OFFIaRIMEMBER EXCLUDED? � <br />(Mralda0scr In NH) <br />WRIfes doscribe uncia, <br />IP OP RA IO $ bel <br />NIA <br />WC TA - OTH <br />E.L EACIIACCIDENT $ <br />P.L. DISEASE • EA EMPLOYEE $ <br />E,L, DISEASE -POLI Y LIMIT <br />A <br />Property Secklon _ - <br />680.18716605 <br />12101/2017 <br />1210112018 <br />DESCRIPTION OP OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Romadce Sohadulo, if more spsoois requirod) <br />ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY: CITY OF <br />SANTA ANNA,ITS OFFICERS, ZNPLOYZt$, AGEINTS, t1OLUTEERS ,AND <br />REPAUS9NTATIVAS//ADlD1T'XONA1 INSURED IS PRX Y AND NON CONTRIBUTORY <br />AGREEMENT NIMBRS A--2011-0701 A-2014-038 & A^-201.5.159//AS REQUIRED BY <br />WRITT�4N CONTRACT, CERTIE'TCATHS ARM SUBJECT TO ALL POLICY TERMS AND CONDIPqN <br />REVIEWED BY: EUNICE. H :REDIA (PG OF ) <br />itsr:rvr�r v v rc t,:AlNVr_L,L.A1 VN <br />SANTAAN <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS, <br />PUBLIC WORKS AGENCY <br />ATTN: JASON GABRIEL AUTHORIZEDREPR9SENTATIVF <br />20 CIVIC CENTER PLAZA M-36 <br />SANTA ANNA, CA 92701 <br />V IUUU-201U AUUKU GORI'OKA7'ION, All rights reserved, <br />ACORD 26 (2010106) The ACORD name and Toga are registered marks of ACORD <br />