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AC CERTIFICATE OF LIABILITY INSURANCE DA DA1 0 /11511 3Y THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE bOEB NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(Ioe) Must" endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such ondorsement s . PRODUCER Alllanl Insurance SerYice3, Inc. 1301 Dove St., Suite 200 Newport Beach, CA 92660 949 - 756 -0271• Fax 949 - 756.2713• License No. 0036861 CONTACT NAME: PHONE: PHONE: NO. NO, EMAIL ADDRESS: —� 70DUCER: "" —"' -- CUSTOMER 100 INSURED: SPECIAL UABI LITY I N SURANCE PROG RAM(SU P)ME M DER: PAINT YOUR HEART OUT, INC. 1260 N. HANCOCK, SUITE 103 ANAHEIM, CA 92807 ....- ...._........_____— INSURERS) AFFORDING COVERAGE SAID IF INSURERA: ASSOCIATED INDUSTRIES INSURANCE CO.___ 23140 INSURER B: INSURER C'. 09/29113 _ INSURER C: EACH OCCURRENCE INSURERS T INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN IS SUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. PR TYPE OF INSURANCE AItisR °, POLICY NUMBER (MMIDDIYY) (MM /DDIYY) LIMITS A GENERAL UADILITV X PAC 100008202 09/29113 09129/14 EACH OCCURRENCE _ $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TORE NTED PREMISES Ea Occurrence $1 300)000 MEDEXPR(Anyonepersom) N/A 01CRUSDADE ® OCCUR PERSONAL &AOV INJURY $1,000,000 OL Of $1003 GEN L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE NA" PPLGY PRO- LOC TECRD PRODUCTS- COMPIOP AGG. $1,000,000 A AUTOMOBILE LIABI LITY PAC 100008202 09/29113 09/29/14 CO BINdED SINGLE LIMIT LEA $1,000,000 BODILY INJURY ( Per person) ANY AUTO BODILY INJURY (Per acedeni) ALL OWNED AUTOS SCHEDULED AUTOS PROPERTY DAMAGE HIREDAUTOS NON -ONNED AUTOS AUTODEO: $1.000 ,Vy�re+Y. T(AN i 3 yry vy�� �jlLN+ PAY A,,Ui a X X UMSREL LA LIAR OCCUR RL'j? �'It'� .�' EACHOCCURRENCE EXCESS LIAR MADE MADE ..GG�A `L _ —° ; I(OQ,l AGGREGATE DEDUCTIBLE RETENTION C E. 4 -YO t Clt)l F "�tYCY ) WORKERS COMPENSATION AND EMPLOYERS LIABILITY xu_ 5 we sTATU- oTw roar umrcs ER AVY PROPRIETCEYDARICER IEXECUrIVE OFFICER I MENIM P1111 -d EU? u NIA L L. EACH ACCI OF NT E.L. DISEASE - EA EMPLOYEE NANOA70BY IN XNJ IF YES OE9CRIBE ORDER DESCRIPTION IF RERATICrve BELOW EL. DISEASE - POLICY LIMIT DESCRIPTION OF OPE RATIO NS) LOCATIONSN ERIC LES IAMdI Aeerd 101, Addmonel RemaAs senmwes, If more a mea Is nqulredl 'POLICY FORM DOES NOT CONTAIN A GENERAL LIABILITY ACCR ELATE AS RESPECTS TO THE AGREE CENT 'A I THE CITY OF SANTA ANA. THE CITY OF SANTA ANA, ITS OFFICERS, AGENTS AND EMPLOYEES SHALL RE NAMED AS ADDITIONAL INSURED, THIS INSURANCE IS PRIMARY AND ANY OTHER INSURANCE OR SE LFJ NSURANCE MAINTAINED BY SUCH ADDITIONAL INSUREDS IS EXCESS AN NONCONTRIBUTING WITH THIS POLICY. SEVERABI LITY OF INTERESTS. THE TERMS' PARTICIPATING NAMED INSURED" AND "INSURED" ARE USED SEVERALLY AND NOT COLLECTIVELY, BUT THE INCLUSION HEREIN OF MORE THAN ONE "PARTICIPATING NAMED INSURED" OR "INSURED" SMALL NOT OPERATE TO INCREASE THE LIMITS OF THE "COMPANY'S" LIABILITY. ADDITIONAL INSURED ENDORSEMENT ATTACHED, SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS. CERTIFICATE HOLDER CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN: FRANK HERNANDEZ THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MANAGEMENT ANALYST ACCORDANCE WITH THE POLICY PROVISIONS, COMMUNITY DEVELOPMENT AGENCY AUTHORIZED REPRE55TfATIVEADMINISTRATIVE SERVICES DIVISION 20 CIVIC CENTER PLAZA. SANTA ANA, CA 92701 ACORD 29130091091 T. ACORO name and logo are NaAWTO madY 0 ACCRA 0200a ACORD CORPORATION, A11,4,mnerved.