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�'k ®® CERTIFICATE OF LIABILITY INSURANCE DATE( MIDD/Y 5/1/2014vvv) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES 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(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be 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 endorsement(s). PRODUCER Assistance Insurance Agency 13732 Newport Avenue - Suite 1 Tustin CA 92780 CONTACT Dori Jared-Ferranto NAME: PNONE (714)245-2777 FA(AICX, No; (714)245-278E aoopaE s: djared@assistanceins.com INSURERS AFFORDING COVERAGE NAICN INSURERA:State Compensation Insurance INSURED Manuel Huante, DBA: Stage Plus, Inc. 2330 S. Susan St. Santa Ana CA 92704 INSURER B: INSURER C: INSURER D: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:14-15 WC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH 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. INSS LTR TYPE OF INSURANCE ADDL JUL SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYYl LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ee occurrence $ CLAIMS -MADE EOCCUR MED EKE (Any one person) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO- LOC1 JECT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Be accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Par accident) $ PROPERTY DAMAGE Peraccident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERI17)(ECUTIVE❑ WCSTATU- OTH- TORY LIMITS ER E. L. EACH ACCIDENT $ 1,000,000 (MandatoryOFFICERJMIn H)EXCLUDED? (Mandatory In NH) NIA 1786318-14 5/1/2014 5/1/2015 E, L. DISEASE -EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Santa Ana, its officers, employees, agents, volunteers and representatives Proof of Insurance FORM � ,�pVE'� 0 TO pRCK 4.1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Santa And ACCORDANCE WITH THE POLICY PROVISIONS. Parks, Recreation & Community 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 Don Bared--fen-ado D Jared-Ferranto/STEP ACORD 25 ©1988-2010 ACORD 1NSn25 rcmnnsim The Arnan r,crr,o P.,n In —. Icfcu,. Iof Arnan