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° °® CERTIFICATE OF LIABILITY INSURANCE °oaios/2o;z ' <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 polley(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the <br />farms 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 Ileu of such endorsement(s). <br />PRODUCER JOSE GASTELUM STATE FARM AGCY NAME':' JOSE GASTELUM <br />24'13 S. FAIRVIEW ST. STE. J FNGNE .7'14-557-3344 ac No:7t4-327- ? 8 <br />E-MAIL <br />SANTA ANA, CA 92704 ADDRESS: 'ose. astelum.LBLS statefarm.com <br />- - INSURER 3 AFFORDING COVERAGE NAIC # <br />INSURED Jose Gastelum Insurance Agency <br />1780 E McFadden Ave., Ste 114 <br />Santa Ana CA 92705 <br />COVERAGES CERTIFICATE NI <br />RFVICIAIJ IJl la <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 />, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ILTR TYPE OF INSURANCE AD UBR POLICY NUMBER M?DDYM(YY M?DDY/YYYY LIMITS <br />A GENERAL LIABILITY ? ? 92-CC-G687-2 O'1/O'1/20?2 O'1/O'1/20f3 EACH OCCURRENCE $ 2,000,000 <br /> X COMMERCIAL GENERAL LIABILITY <br />PREMISES Ee occtrrrance <br />$ <br /> CLAIMS-MADE ? OCCUR <br /> MED EXP (Any one person) $ 5,000 <br /> PERSONAL 8 ADV INJURY $ 2 <br />000 <br />000 <br /> , <br />, <br /> GENERAL AGGREGATE $ 4 <br />000 <br />000 <br /> , <br />, <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000 <br /> X POLICY PRO LOC BUSN PROP. <br />$ 25,000 <br /> AUT OMOBILE LIABILITY MBIN IN LE LIMIT <br /> ? Ea accident $ <br /> ANV AUTO BODILY INJURY (Per person) $ <br /> ALL OWNED SCHEDULED <br /> AUTOS AUTOS BODILY INJURY (Per accident) $ <br /> HIRED AUTOS NON-OWIJED <br />AUTOS PROPERTY DAMAGE <br />Per eccitlen[ <br />$ <br /> <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> E%CE3s LIAR CLAIMS-MADE AGGREGATE $ <br /> <br /> DED RETENTIONS $ <br />B WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS' LU\BILITY y / N 92-67-C54'1-7 07/07/20'1'1 07/07/20'12 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICE/M EM BER EXCLUDED? Y? <br />N / A EL EACH ACCIDENT $ 500,000 <br /> (Mandatory in NH) <br />If <br />tl <br />nb EL DISEASE - EA EM PLOVE $ 500,000 <br /> yes, <br />esc <br />e under <br /> E. L. DISEASE-POLICY LIMIT $ 500,000 <br /> <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (AttaeF, ACORD 101, Atlaltlonal Rarearka Senadule, Ir more apace I? <br />Z? <br />Providing State Farm insurance and financial services to the public. R5 <br />_ <br />YR?V£D <br />`? ? <br />ST ORCK <br />e <br />?ty Attorc? y <br />a? . <br />\- <br />C <br />?s <br /> <br />OLDER <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana CA 9270'1 <br />ACORD 25 (20'10/05) <br />The ACORD name and logo are <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 />©'1988-2070 ACORD CORPORATION. All rights reserved. <br />narks of ACORD ? 001486 ? 32849.6 11-? 5-20'1 O <br />Exhibit C