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DATE <br />A� CERTIFICATE OF LIABILITY INSURANCE <br />PRODUCER <br />M agulrs ra lnsunce Agency, Inc. <br />27101 Puerta Real Sults 200 <br />Mission Viejo, CA 92691- <br />877.438.7459 <br />INSURED <br />Chlhlro Sano <br />106 Yorktown La <br />Costa Mesa, CA 92626 - <br />COVERAGES <br />THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />USURER A: <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERIFICATION MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />ADD'L <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LTR <br />Hal <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE(MM/00/YYYY) <br />DATE(MM/DD/YYYY) <br />LIMITS <br />A <br />X <br />GENERAL LIABILITY <br />PHPK803569-003 <br />12/08/2014 <br />12/08/2015 <br />EACH OCCURENCE $1,000,000 <br />% COMMERCIAL GENERAL LIABILITY <br />PREMISES Ea occurrence $500,000 <br />CLAIMS MADE F OCCUR <br />MED EXP (Any one person) $2,500 <br />PERSONAL &ADV INJURY $1,000,000 <br />% PROFESSIONAL LIABILITY <br />GENERAL AGGREGATE $3,000,000 <br />PRODUCTS — COMP/OP AGG $3,000,000 <br />GENTAGGREGATE LIMIT APPLIES PER <br />X POLICY PROJECT LOC <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />ANYAUTO <br />(EA accident) <br />BODILY INJURY <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />(Per person) <br />BODILY INJURY <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />(Per accident) <br />PROPERTY DAMAGE <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY— EA ACCIDENT <br />OTHERTHAN EA ACC <br />ANYAUTO <br />AUTO ONLY: AGO <br />EXCESS / UMBRELLA LIABILITY <br />EACH DCCURENCE <br />OCCUR F7 CIAIMS MADEp <br />7 <br />AGGREGATE <br />0 <br />DEDUCTIBLE <br />C/ <br />?,0 <br />RETENTION <br />bLUMPtNbAIIUNANUTALL) <br />EMPLOYERS' LIABILITY I�Y/N <br />FFR%RR/CLE%E%ECUTIVEOICEMEMBER%UDp <br />(Mandatory, In NH) <br />eNI <br />sTr <br />�, ` <br />U <br />1OFy Leurs ER <br />EL EACH ACCIDENT <br />E.L. DISEASE — EAAMPLOYEE <br />Iyes escribe under <br />f <br />SPECIALdPROVISIONS below <br />\\`'\a,� <br />�1 <br />E.L. DISEASE— POLICY LIMIT <br />OTHER <br />DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />Itis understood and agreed that the following entity is added as an additianal insured but only with respect(s) to the operations of the named Iran red except that lla bility resulting from the additio nal insu red's sole <br />negligence. <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />Attu: Silva Cuevas <br />26 Civic Center Plaza <br />Se ate Ana, CA 92701- <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE <br />THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE <br />CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR <br />LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />