Laserfiche WebLink
.Aih v CERTIFICATE OF LIABILITY INSURANCE <br />°osmg/22o,4Y' <br />THIS CERTIFICATE 18 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 INSURE 1-490 It t t e %rsed. If SUBROGATION IS WAIVED, subject to the <br />terms and conditions of the policy, certain policies may require an an orsement. at teddlakflTlt on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsennent(s). <br />PRODUCER Eddie Quiliares Jr. LA I yM <br />State Farm Agency CLEF <br />416 N. Broadway <br />�t Santa Ana, CA 92701 <br />z <br />FAC U7j481771 S_ __. _. <br />� ' <br />E-MAIL <br />ADDRESS: Oddfa addie�t i_nsurance.GOm <br />IN$URER(S) AFFORDING COVERAGE <br />NAIC e <br />INSURERA: State Farm Fire and Casualty Company <br />INSURED Sandra Pena Sarmient0_— <br />DBA OC Film Fiesta Santa Ana <br />910 Grant St �t <br />(51 IDS <br />Santa Ana, CA 92701 <br />INSURER C: <br />INSURER 0: <br />NSURERE: <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER:76-0450 REVISION NUMBER: <br />'PHIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSP <br />_OF <br />—vvvLTR TYPE OPINSURANCEA <br />EVER <br />POLICYNUMBER <br />POLICY EFP <br />MMD YEXP <br />LIMITS W <br />A <br />GENERAL LIABILITY <br />92-C3.N778.3 <br />09/09/2014 <br />09/09/2015 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />COMMERCIAL GENERAL LIABILITY <br />PREMISES (EGST0_ATRTrD_'-- <br />$ <br />CLAIMS -MADE OCCUR <br />MED EXP (Any One Person) <br />PER60NAL S ADV INJURY <br />$� <br />— <br />GENERAL AGGREGATE <br />_ <br />$� 2,000,000 <br />PRODUCTS - COMPIOP AGG <br />$ 2,000,000 <br />GENL AGGREGATE LIMITAPPLIES PER: <br />MO- LOC <br />POLICY L <br />Business Personal Pro <br />$ 6,000 <br />AUTOMOBILE LIABILITY <br />'lt�� <br />COMBINED 1 LIMIT$ <br />Ea <br />_ <br />_ ANY AUTO <br />�1 <br />n v R <br />i+i7 <br />JL <br />BODILY <br />9001LY INJURY (Par parson) <br />INJURY <br />$ <br />ODILY INJURY (Per eCclponq <br />-� <br />$ <br />ALL C4MlED SCHEDULED <br />AUTOS AUTOS <br />A <br />q� 8d <br />PRrF I <br />$—_ <br />_ HIRED AUTOS AUTOS <br />$ <br />JT O <br />UMBRELLA LIAe OCCUR <br />c',ty <br />EAGH OCCURRENGE^__ <br />EXCESS UAa CLAIMS+`AADIE <br />ASSISt <br />f1t <br />n ! <br />AGGREGATE <br />DED RETENTIONS <br />WORKERS COMPENSATION <br />WC STATV. OTH- <br />j AND EMPLOYERS'LIABILITY YIN <br />SOd1Yi1 FIR <br />ANY PROPRIETOP/PAR7NERIEXECUTiVE r--7 <br />OFFICEIMEMSER EXCLUDED? L_J <br />NIA <br />E.L EACH ACCIDENT <br />$ <br />(Mandatary In NIN <br />E.L. DISEASE - EA EMPLOYE <br />$ <br />it yea, detcnba under <br />QI5qCR-PTION OF OPERATIONS ldtllv�E.L. <br />DISEASE -POLICY LIMIT <br />$ <br />F19 <br />DESCRIPTION OF OPERATIONS / LOCATIONS!VEHICLES (Attach ACORD 101, Additional Roma" Schedule, if inure apace Is required) <br />City of Santa Ana It's officers, agent employees and Volunteers are named as additional Insured. <br />CERTIFICATE HOLDER CANCELLATION <br />City Santa Ana <br />SHOULD HABOVE POLICIES CANCELLED BEFORE <br />of <br />EXA IONDATE THE EOF,, NOTIICE WILLL OF DEL VERED THEEXPIRATION IN <br />20 Civic Center Plaza <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, GA 92702 <br />AUTHORIZED REPR 6rjTA"f4 E <br />Briza Molares <br />f/ �f <br />ram' l� <br />(D1988.2010 ACORD ORPORATION. All rights reserved. <br />ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 <br />