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0 DATE (6I WDDNYYY) ACoORV �- CERTIFICATE OF LIABILITY INSURANCE 5j12J2016 THI[SI 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 CONST'ITUT'E 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 CONTACT DiAnna Martin NAME: PRCONE (916) 791i�9®7n AdC No:, (915)784FAX -6158 All -Cal Insurance Agency 5.05 Vernon Street E-MAIL dial'fPlle9@c1ll°`Cc1linsuralnce.com ADDRESS: INSURER ($) AFFORDING COVERAGE NAIC it X COMMERCIAL OENERAL.LIA131LITY INSURER A:Non rofits ° Insurance Alliance of NTAC Roseville CA 95578 INSURED INSURERIB:State...C©K ens'a'tion Insurance Fund 35076 INSURER C: The Los Angeles Dream Shaper's P.O. Box 3831 � � . � INSURER D: INSURER E: INSURER F: ''..... O,range CA 92865 COVERAGES CERTIFICATE NUMBER:CL1651205392 REVISION NUMBER: - THIS IS TO CERTIFY THAT THE POLICIES OF I'N'SURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH 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. _.. INSR LTR TYPE OF INSURANCE ABDUL DUL Su R POLICY NUMBER POLICY EFF MMIDDIYYYY' POLICY EXP MMIDDIYYYY LIMITS X COMMERCIAL OENERAL.LIA131LITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE }C1 OCCUR PREMISES Eacccurcence $ 500,000 MED EXP (Anyone parson) $ 20,000 X LIQUOR LIABILITY X 2016-08605INPO 6/13/2016 6/13/2017 1 000 000/ 1,000,000 PERSONAL &ADV INJURY $ 1,000,000 GENT AGCGRF.GATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 PRO- POLICY JECTF7LOC PRODUCTS - COM PIOP AGG $ 2,000,000 Liquor Liability 8 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 000 000 Ea sec¶den& r r BODILY INJURY (Per person) $ ANY AUTO A ] ALL OWNEDSCHEDULED AUTOS FtUTOS 2015-086fl9NP0 6/13/2016 6✓13✓2017 _ BODILY INJURY (Per accident) $ NON-OWNIED PROPERTY DAMAGE .Per accdent HIRED AUTOS AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTIONS $ WORKERS COMPENSATION PER - AND EMPLOYEIRS'LIABILITY Y ! N STAT TE E ANY PROPRVETORJPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 $ OFFICER/MEMBER EXCLUDED? U (Mandatory In NH) NIA 9015327-15 6/6/2015 6✓6/2017 .--------- E.L.DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L- DISEASE -POLICY LIMIT' IS 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) 'INSURED THE CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE NAMES UMFR �0 THE TERMS 09 THEIR CONTRACT., INSURANCE IS PRIMARTY AND NONCONTRIHUTR.Y,a�. 10 APPLIES 1 Jp CITY' OF SANTA ASIA ATTN. PURCHASING DEPARTMENT 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 ACORD 25 (2014/01) 1 NS025 (201401 ) Ley_1.1i1413>l.R:,11L�1i l ^1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Q 1998-2414 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD