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BELLB -1 OP ID: SO <br />CERTIFICATE OF LIABILITY INSURANCE oe'112211 �' <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(ies) must be endorsed. If SUBROGATION IS WAIVED, subjec! 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 />PRODUCER <br />INSURED <br />(M) Fax: <br />110 <br />Mrs. Yang Chanhee <br />5170 Sepulveda Blvd., #180 <br />Sherman Oaks, CA 91403 <br />Preserver <br />Insurance <br />CnVPPARFS CERTIFICATENUMBER: 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. <br />L1 F INBURANCE L POLICY NUMBER MMIOOM/YV MMIODNYYY LIMITS <br />Y <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />EACH 6CCURRENCE <br />$ 11060160 <br />B GENERAL LIABILITY <br />x x <br />u6A4629224 01110!14 01110/96 <br />A >`E`rd"RENTLO <br />PREMIS�$'Ga occurtenca <br />§ 106,00 <br />ADE OCCUR <br />rYE" <br />MED E %P (Any ona peredOl <br />$ 5r66 <br />PERSONALRADVMIURY {$ <br />— <br />1,606,66 <br />�Vq <br />to <br />� <br />GENERAL AGGREGATE <br />$ 2x000 06 <br />E LIMIT APPLIES PER'. <br />y,f <br />LOA <br />PRODUCTS GOMP IOP AGG <br />$1,666x66 <br />".... <br />$ <br />PRO- LOC <br />1 A <br />AUTOMOBILE LIABILITY <br />�+ 'I <br />COMBINED SINGLE LIMIT <br />Ea acoldu t <br />ANY ALRO <br />y, <br />�6y��YSA*`�Lp�.�,Q, <br />L��++��..pp��LT4` <br />BODILY INJURY(Per Peragnj <br />§ <br />ALL OWNED <br />AUTOS AUTOS <br />{ L�'.7 <br />ROOILY INJURY (Pnt accident)$ <br />�SCIIEDULED <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />Oil °tSyWTt <br />PROPERTY DAMAGE <br />„ Perawitle It <br />$ <br />$ <br />UMBRELLA LIAR X OCCUR <br />EACHOCCURRENCE <br />$ 6,000,00 <br />t' X <br />EXCESS ITAS CLAIMS -MADE <br />XL6604652 -01 01/10114 01/10116 <br />AGGREGATE <br />` <br />$ 5,000,06 <br />OED X RETENTIONS <br />$ <br />WORKERS COMPENSATION <br />X WC STATU- 0TH. <br />CRY R <br />AND EMPLOYERS' LIABILITY <br />A AM /PROPRIETGRIPARTNERIEXECUTNE Y t N <br />CC OOD4991 65/02113 05102/18 <br />_ER <br />E,EACH ACCIDENT <br />'$ 1,666,66 <br />OFFICERIMEMBFR EAGWOE04 <br />{Mantlatwy irz AU <br />N(A <br />fit. DISEASE - EA EMPLOYEE <br />$ 1,006,60 <br />H yaa, describe under <br />DESCRIPTION OF OPERATIONS below <br />E. L, DISEASE - POLICY LIMIT <br />1,000,00C <br />$ 1,666,66 <br />1 <br />ofi CMPT*N OF OPERATIONS! LOCAT1ONSf VEHICLES (Attach ACORD iCi, AWtl nai Remarks Suhedul %it mwa sp o b mqu(reril <br />Certificate holder, its officers, employees, agents, and representatives are <br />named as Additional Insured in regards to the general liability where <br />required by written contract, with primary and non - contributory wording in <br />respects to the operations or the Warne Insured, <br />CFRTIFICATF HOLDER CANCELLATION <br />CITYOFS <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 />City of Santa Ana <br />Purchasing Department <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92702 <br />©1988.2010 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2010/06) The ACORD namo and logo are registered marks of ACORD <br />