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CERTIFICATE OF LIABILITY INSURANCE
<br />ATE
<br />b05/06/201 Y,
<br />POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />-ixsado9
<br />LI .._....._..-----'--- -...__ .-----' ........_..._.___....
<br />-FOIaGTY EFP'L-CYNE P4LICV ERPIRATO --_._.._,__
<br />LTR INSRO TYPE OFINSURANC,E POLICY NUMBER DATE MMIDONY GATE (MM/OO/YY LIMITS
<br />05/06/2019
<br />PRODUCER
<br />Ric Welssinge.r
<br />Insurance Agency, Tnc.
<br />THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />Ri.c Waise:i.nger,
<br />Agent Lic 4 OC69161.
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />5922 Warner Ave,
<br />Huntington Beach CA 92649
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />INSURERS AFFORDING COVERAGE
<br />NgIC qp
<br />INSURED
<br />O C aATH,IY INC
<br />PRL-'MA�j �SL$(Cu �u�Ierlan)`y
<br />INSURERA.State Farm General Insurance Company 25151
<br />-'
<br />_.. ._.._.
<br />1940 N TUSTIN ST
<br />SIT, 103
<br />INSURER B:
<br />ORANGE CA 92865-4642
<br />MED EXP,�Arry ono parsol�
<br />INSURER C:
<br />INSURER
<br />_--.4_...__._�..._.._.._.._._._..
<br />INSURER Il V -
<br />PERSONAL&AUV INJURY_
<br />$__ .L, OPO, OOP
<br />—
<br />_
<br />91 2, OOPrODD
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA"FED. NOTWITHSTANDING
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />-ixsado9
<br />LI .._....._..-----'--- -...__ .-----' ........_..._.___....
<br />-FOIaGTY EFP'L-CYNE P4LICV ERPIRATO --_._.._,__
<br />LTR INSRO TYPE OFINSURANC,E POLICY NUMBER DATE MMIDONY GATE (MM/OO/YY LIMITS
<br />Y.
<br />X
<br />GENERAL LIABILITY
<br />92-CC7-ECC191-9 G
<br />04-02-2014
<br />04-02-201.5
<br />E.ACHOCCURRENCE
<br />S 1,000r PPO
<br />LAHORVE- E$ T i
<br />.• ly° • G'LbHY'€,irlger, Agent
<br />Y' COMMLRCIAL GENERAL�jLIAUILITY
<br />PRL-'MA�j �SL$(Cu �u�Ierlan)`y
<br />J.00, 000
<br />CLAIMSMAOE El OCCUR
<br />MED EXP,�Arry ono parsol�
<br />,$-� 5,000
<br />_--.4_...__._�..._.._.._.._._._..
<br />PERSONAL&AUV INJURY_
<br />$__ .L, OPO, OOP
<br />—
<br />GFNFRAL AGGFEGA'E
<br />91 2, OOPrODD
<br />GEN'LAGGRF.GAIE LIMIT'APPUESPER
<br />PRODUCTS-COMPlAf1I1 $
<br />2, OOP, POP
<br />X
<br />x LICY n"i X LOC
<br />PO
<br />—
<br />_- --
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />ANY AUO
<br />T
<br />(Ea 8.ee,,Q
<br />$
<br />ALL OWNED AUTOS
<br />SODILY
<br />—-��---------
<br />SCHEDULED AUTOS
<br />(1'er rparw parwn)
<br />HIRED AUTOS
<br />BODILY INJURY
<br />NON -OWNED AUTOS
<br />(Per awldonU
<br />$
<br />PRO PERI'Y DAMAG E
<br />$
<br />-
<br />j(Per
<br />accident)
<br />GARAGE LIABILITY
<br />NT
<br />AU7AGG
<br />$
<br />OTACC
<br />$
<br />ANY AUTO
<br />AUGO
<br />$
<br />CXCESSIUMBRELLA LIABILITY
<br />EA,qOCGJR
<br />AGS
<br />OCLAWSMADE
<br />DEDUCTIBLE
<br />---------_._
<br />_
<br />RETENTION S
<br />T
<br />$
<br />WORKERS COMPENSATION AND
<br />WCSTATU- OTH-
<br />EMPLOYERS' LIABILITY
<br />TG, LIMITS GR
<br />ANY PROPRIETOR/PART'NERIEXLCUTIVE
<br />OFFICEWMEMHER EXCLUDED?
<br />E. L. EACH ACCIDENT
<br />—
<br />__$_
<br />E.L. DISEASE,-AEMPLOYEE
<br />--
<br />$
<br />Iryoe,dewberinder
<br />SPECIAL PROVISIONS balaw
<br />EL DISEASE- POI..ICY LIMIT
<br />$
<br />X
<br />OTHER
<br />I3Dsinc,ss Property
<br />92-CD-KO91-4 G
<br />04-02-2014
<br />04-02-2015
<br />$ 45,000
<br />DESCRIPTION OP OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
<br />Loc 41 - 1940 N T'USTTN ST STE 103, ORANGE, CA 92865
<br />CERTIFICTE HOLDEE, ITS OFFICERS, AGENTS ARID EMPLOYEES ARE NAMED AS ADDITIONAL INSURED IN REGARDS
<br />TO GENERAL LIABILITY PER ATTACHED FE6609
<br />O ICO.S inC Ic
<br />132049 03-13-200; 9 aeownershipof e mars y elf respe Ive Owners c
<br />All rights
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />CITY OF SANTA ANA
<br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL30 DAYS WRITTEN
<br />ATTN: PURCHASING DEPARTMENTNOTICE
<br />TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50$HALL
<br />20 CIVIC CENTER PLAZA
<br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
<br />SANTA ANA, CA 92701.
<br />SENT
<br />TIV
<br />LAHORVE- E$ T i
<br />.• ly° • G'LbHY'€,irlger, Agent
<br />ACORD 25 (2001108, 1 e reIs r0 Ion n t
<br />O ICO.S inC Ic
<br />132049 03-13-200; 9 aeownershipof e mars y elf respe Ive Owners c
<br />All rights
<br />
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