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A� R °® CERTIFICATE OF LIABILITY INSURANCE <br />7�25�20 4W' <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, 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 <br />NAME: Li Zette Bargas <br />Amorelli Rosemann & Associates Insurance <br />PHONE (909)987 -7600 FAX (909) 9B7-7656 <br />AC o: <br />3333 E Coneours St <br />EMAIL <br />DDRE ,lizetteb @arainsurance.com <br />INSURERS AFFORDING COVERAGE <br />NAIC0 <br />Building 9 -.200 <br />INSURERA:State Comp. Insurance Fund <br />35076 <br />Ontario CA 91764 <br />INSURED <br />INSURER B <br />INSURER C: <br />Mdg Associates, Inc. <br />INSURER D: <br />TO RENTF7-- <br />DAMAGE PREMISES Eeeccu ence <br />10722 Arrow Route Ste 822 <br />INSURER E: <br />CLAIMS -MADE OCCUR <br />INSURER F: <br />Rancho Cucamonga CA 91730 <br />COVERAGES CERTIFICATE NUMBER:CL145109116 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 />LTR <br />TYPE OF INSURANCE <br />ADDLE <br />BR <br />POLICYNUMBER <br />MMLIpY� <br />MOIDDIYYY <br />LIMITS <br />GENERAL LIABILITY <br />._;rye• i ' �� G7 <br />Cerda /MAIiICE "n <br />Maricela <br />EACH OCCURRENCE <br />$ <br />COMMERCIAL GENERAL LIABILITY <br />TO RENTF7-- <br />DAMAGE PREMISES Eeeccu ence <br />$ <br />CLAIMS -MADE OCCUR <br />MED EXP(Any one person) <br />$ <br />PERSONAL B ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />$ <br />GENL AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGO <br />$ <br />POLICY PRO .7 LOC <br />$ <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Re accident <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />ALLOWNE❑ SCHEDULED <br />AUTOS <br />BODILY INJURY (Per accldent) <br />$ <br />PROPERTY DAMAGE <br />Peraccidet <br />$ <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS LIABILITY <br />ANY PROPRIETORIPARTNERIEXECUTIVE 0 <br />X WCSTATT ER <br />E.L. EACH ACCIDENT <br />$ 11000,000 <br />OFFIGERIMEMBER EXCLUDED9 <br />(Mandatory In NH) <br />NIA <br />1980750 -14 <br />7/1/2014 <br />7/1/2015 <br />E.L. DISEASE -EA EMPLOYE <br />$ 1,000,000 <br />r yes, SORPTION under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEAGE POLICV LIMIT <br />$ 1,000,000 <br />PP12 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more ace <br />PROOF OF INSURANCE FOR CERTIFICATE HOLDER. <br />Plnudd� <br />3ose Sando oAssistant City Attorney <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2010/05) <br />INS025 oninnSl n1 <br />©1988 -2010 ACORD CORPORATION. All rights reserved. <br />The ArnRn n.mc and Inns am rcniefnrnfl mark. of ernRn <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 />ATTN: TERRI EGGERS, SENIOR MNGMT. ANALYST <br />AUTHORIZED REPRESENTATIVE <br />COMMUNITY DEVELOPMENT AGENCY <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92701 <br />._;rye• i ' �� G7 <br />Cerda /MAIiICE "n <br />Maricela <br />ACORD 25 (2010/05) <br />INS025 oninnSl n1 <br />©1988 -2010 ACORD CORPORATION. All rights reserved. <br />The ArnRn n.mc and Inns am rcniefnrnfl mark. of ernRn <br />