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LC..R CERTIFICAT OF LIA ALIT 1 INSURANCE
<br />DATE IMMIDDIYYI'Y)
<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 polleytes) 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 />PRODUCER Phone: (707)996-,912
<br />Pax; (7077996-7912
<br />Apollo General tnsuxance Agency, Ina (I)
<br />a. Box I sns
<br />CONTACT Joel, e Lewis
<br />E T�-
<br />afNNp P n �I iAl Nor
<br />MAIL jertcol@apgen.com
<br />n.com_
<br />INSURER,$ AFFORDING COVERAGE
<br />Nalcs
<br />Sonoma, California 95476
<br />INSURERA; irrterstate FiIo&CaSUaItVCompany
<br />_
<br />22$29 !
<br />$ J
<br />INSURED
<br />INSURERS: Arner{can Automobile ftsurancLqompany
<br />21849
<br />INSURER D: Torus Speciality Insurance Company
<br />=14776
<br />J&G Industries, Inc.
<br />INSURER o; Westchester Surphls Lines Insurance Company
<br />10172
<br />18627 Brookhurst Street
<br />PMB 302
<br />Fountain Valley, CA 92708 p
<br />SURER E: y
<br />C.tAIMS-MARE OCCUR
<br />----
<br />WARNING:
<br />YV,
<br />NSURERF:
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<br />iskired Status on
<br />COVERAGES CERTIFICATE NUMBER: 362 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.
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<br />024114004002
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<br />DESCRIPTION OF OPERATIONS I L000.uONS!VEHICLES (Attach ACORD 161. Addltlonei Remarks Schedufa, li nwra space is mquirsd)
<br />ne All egerationa of the Named Insured. Too Cly of Seita Ana, its officers, agents, s employees are named as
<br />addiaional insureds and additional lnaured coverage is provided .f regUi'red by writian contract pAerw r�ycyRr.y.pin.�M
<br />herato attached. APKU b 11 �l..%%PVVAA�<
<br />Laura A. Rossano I
<br />Holder's Nature of ImefcsL Certificate Holder
<br />City of Santa Ana
<br />20 Civic Center Plaza N136
<br />Santa Ana, 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 />Q 1988-2010 ACQFMCORPORATION. All
<br />ACORD 26 (2010/06) The ACORD name and logo are registered marks of ACORD
<br />
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