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AC4r->'2V CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DD/YYYY)
<br />9/14/20 1. 7
<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(les) 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 Ileu of such endorsement(s).
<br />PRODUCER Phone: (707)996-2912
<br />Fax: (707)996-7912
<br />Apollo General Insurance Agency, Inc. (1)
<br />P. O. Box 1508
<br />CONTACT Jerilee Lewis
<br />NAME:
<br />PHONE o
<br />apgen.com
<br />ADDRESS: jer"oel@aPgen.com
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />Sonoma, California 95476
<br />INSURER A: Interstate Fire & Casualty Company 22829
<br />DAN 1000477
<br />INSURED
<br />INSURER B: American Automobile Insurance Company 21849
<br />American Wrecking, Inc.
<br />INSURER C: Starstone Specialty Insurance Company 44776
<br />2459 Lee Avenue
<br />South El Monte, CA 91733INSURER
<br />INSURER D: State Compensation Insurance Fund Of California 35076
<br />E : Tokio Marine Specialty Insurance Company 23850
<br />INSURER F:
<br />lRiRl9 a:�GK7� U�:i 117[9_ I� � DL'll=i �: :7 �q F.9It17. �. I16rd:1 �:
<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 />ILTR
<br />TYPE OF INSURANCE
<br />ADD
<br />BR
<br />POLICY NUMBER
<br />MMIDDY EFF
<br />POLICY P
<br />LIMITS
<br />A
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ✓❑ OCCUR300,000
<br />DAN 1000477
<br />4/28/2017
<br />4/28/2018
<br />EACH OCCURRENCE $ 1,000,000
<br />PREMISES Ea occurrence $
<br />MED EXP (Any one person) $ 51-000
<br />PERSONAL &ADV INJURY $ 110001000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY ✓❑ JE0 LOC
<br />GENERAL AGGREGATE $ 2,000,000
<br />PRODUCTS -COMP/OP AGG $ 2,000,000
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />IvIXA80327463
<br />9/1/2017
<br />9/1/2018
<br />Ee BINEDSINGLE LIMIT $ 1,000,000
<br />1/
<br />ANY AUTO
<br />BODILY INJURY (Per person) $
<br />1/1
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED �/ NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />Pereccident
<br />( ) BODILY INJURY $
<br />PROPERTY DAMAGE $
<br />Per acoldent
<br />C
<br />UMBRELLA LIAB
<br />EXCESS LIAR
<br />OCCUR
<br />CLAIMS -MADE
<br />29256E 171ALI
<br />4/28/2017
<br />4/28/2018
<br />EACH OCCURRENCE $ 10,000,000
<br />AGGREGATE $ I0,000,000
<br />DED RETENTION $
<br />$
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y/N
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBEREXCLUDED7
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />9161690-16-2
<br />10/1/2016
<br />10/1/2017
<br />P R OTH-
<br />✓ s ATU E E
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000
<br />E.L. DISEASE • POLICY LIMIT $ 1,000,OQO
<br />E
<br />Pollution Liability
<br />PPK1615467
<br />2/18/2017
<br />2/18/2018
<br />Per Dec. 5,000,000
<br />Policv Aaa. 5,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />Re: Operations of the Names Insured. Certificate Holder is hereby added as Additional Insured if required by written
<br />contract per endorsement hereto. Waiver of Subrogation is provided, as required by written contract with the insured
<br />as respects coverage evidenced herein. A 30 day written notice shall be mailed to the certificate holder at the
<br />address provided herein, should a described policy(s) be cancelled before the expiration date thereof; 10 -day notice
<br />for non-payment of premium.
<br />�a
<br />REVIEWED BY: EUNICE HEREDIA (PG 0 OF )
<br />-11 1-1 IIVL 11 llMIY4GLL/111V IY
<br />Holder's Nature of Interest : Certificate Holder
<br />City of Santa Ana
<br />PO Box 1988 M-36
<br />Santa Ana, CA 92702
<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 />1zxX7,2F^-0-1
<br />988-2015 AqfflRD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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