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DATE CMIMrDDfYYYY9
<br />CERTIFICATE OF LIABILITY INSURANCE �T f�6,✓1s /Ia16
<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 SUB140GATION 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 Milder in lieu of such endorsement(s).
<br />PRODUCER CON ACT �"IT KTF+i _ _
<br />NAME: .__._..
<br />INSURANCE LAND INSURANCE SERVICES PRICNyEoJtl: 213 -3I38 -5505 _ EalyNo} �13 -3t�'6 -74th
<br />4032 WILSHIRE BLVD ADDRESS, insurance)land@gtiail.com
<br />STE 309 INSURER(Sp AFFORDING COVERAGE NAiC q
<br />LOS ANGELES CA 901010 -_......., .._.._._ _.
<br />_In,suRERA COLONY
<br />IusURA_ xCE COMPANY 39993
<br />� 99 9W9._3
<br />INSURED
<br />INSURER B : EtILOYE R PREFERRED INSURANCE 10345
<br />XANASU SERVICE SYSTEM, INC . INSURERC: INTEGO PREFERRED- TNSURAN&i _
<br />,...w
<br />3'1488
<br />3010 WILSHIRE BLVD. SUITE 315 INSURER D:
<br />_INSI�RER E
<br />LOS ANGELES CA 90010 INSURER F: _
<br />,^°r°a%/=Ar-' =Q ( rDT1CIe ATIl:Mnrn M11=0r RFVmirw NIIMRFP-
<br />THIS BS 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 DOCUMI.NT' WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DE$QRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />............ - �..._, ....___,...,�.A47o4atl66Fi _........,.. __...._. :., ....�..., POLICY EF%�POLIt;.Y EXP
<br />INSIi f.... TYPE OF INSURANCE I POLICY NUM DER M.MIOIiIYYV "Y MMMWYYYY LIMITS
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />COMMERCIAL GENERAL LIABRLITY
<br />t_..,,_...
<br />AUTHORIZED RE=PRESENTATIVE
<br />GL4171421
<br />09/15 ✓2015
<br />09115 ✓2016
<br />EACH'.,9 OCCURRENCE
<br />At. "01 iORENTED
<br />$ 1,000,000
<br />_..
<br />OCCUR
<br />S 100,000
<br />CLAIMS -MADE
<br />EREMISF'4LE-3 pt,.argncg}_
<br />ME EXP (Any ano Pefsan}
<br />$ .. 5,000
<br />A
<br />,,. _.
<br />..___ _. __...
<br />Y
<br />Y
<br />PERSONAL & AQV INJURY
<br />5 1,000,000
<br />..
<br />GENE AGGREGATE LIMIT APPLIES PER:
<br />GENER 41 AGGR12GATE �
<br />$ 2,000,000
<br />POLICY PRO- PRO LCC
<br />L...
<br />°
<br />s
<br />PRODO� TS COMPICPAGf
<br />I. $ 1,000,000
<br />-._
<br />OTHER:
<br />4
<br />_ _
<br />S
<br />AUTOMOBILE LIABILITY'
<br />u.......
<br />20031725/88' --01
<br />05/04 /201..5
<br />CQMBINEP
<br />06/04/2017
<br />1NNGCLLILIMII
<br />_tFaatri,ienl}
<br />$ 11000,000
<br />_
<br />ANY AUTO
<br />(
<br />BODILY INJURY (Per parson)
<br />-
<br />O
<br />ALL OWNED SCHEDULED
<br />4
<br />BODILY INJURY (Per accident)
<br />$
<br />AUTOS AUTOS
<br />/._ NON- OWNED
<br />HIRLOAUTOS
<br />i
<br />9
<br />I
<br />..._..��
<br />PROPERTYDAMA1aE
<br />$
<br />_1L AU'70S
<br />L
<br />1 1A.B OCCUR
<br />!
<br />EACH CCCURRENCE
<br />a
<br />EXCESS OAS
<br />AGGRE AIE
<br />_�CLAIMSMADEI
<br />p
<br />OED 1 RETENTION
<br />_
<br />I(
<br />COMPENSATION
<br />"LIABILITY
<br />p
<br />EIG 1663447 03
<br />04/02 ✓2017
<br />ER
<br />STATIiTE ER
<br />AND EMPLOYERS YIN
<br />ANY PR9PRIET0R1PARTNERJLXECUTIVE I�—�+�q
<br />}
<br />.04/02/2016
<br />}
<br />E L EAC H ACGIDE..NT
<br />g 11 0 00 , 0 0 0
<br />B OFFICERWEMBER EXCLUDED? E�J`
<br />(Mtandatory In NH)
<br />N I A
<br />I
<br />I - -- - .., �-
<br />i E.L.. DISEASE - EA EMPLOYEE1
<br />_ . _ —
<br />$ 1,000,000
<br />I
<br />E.L.UISEA E -POLICY LlIT
<br />S 1,000,000
<br />ilf yes, describe under
<br />c - BESCRIFTICN OF OPERATIONS below
<br />i
<br />r
<br />I
<br />DESCRIPTION OP OPERATIONS d LOCATIONS I VEHICLES. ACORD 101, Additional Remarks 5r:heduie, may be attached it moro spaca is requir.dy e
<br />J\
<br />CERTIFICATE HOLDER IS AS AN ADDITIONAL INSURED. /
<br />(,ejy�j
<br />r.��ralrr�rarr�!!rirl�i�- rr��.rM�����rrna�Ir�
<br />CLERK OF THE COUNCIL
<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 />AUTHORIZED RE=PRESENTATIVE
<br />20 CIVIC ' CENTER PLAZA (M-30)
<br />SANTA ANA CA 92701
<br />-
<br />'u-) Itsoo-zuI% MV,Ur%w 11V1U.: n l u lryrlla rvau, I...
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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