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AC40/Z® <br />�r <br />CERTIFICATE OF LIABILITY INSURANCE <br />nAT>w(MMIDDmvY) <br />1/2/2017 <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 po[icy(ies) must be endorsed. If SUBROGATION 1S 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 holder in. lieu of such endorsement(s). <br />PRODUCERNAME: <br />COSTANZA INSURANCE AGENCY INC. <br />PO BOX 550 <br />SUE LINDSTROM <br />PHONE-542-3222FAX <br />AIC Na. EM : - .A1C, No : <br />ADDRESS: S.LINDSTROM@CIA—CA.COM <br />VERDUGO CITY, CA 91046-0550 <br />INSURER(3) AFFORDING COVERAGE NAIC# <br />OBB0250 <br />INSURER A: STEADFAST INSURANCE COMPANY <br />INSURED DZGISTREAM LOS ANGELES, INC <br />INSURER B: <br />18436 HAWTHORNE BLVD. <br />INSURER C: <br />SUITES 102 & 104 <br />INSURERD: <br />INSURER E <br />TORRANCE, CA, 90504 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS 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 DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />iNSR <br />LTR <br />I TYpE OF INSURANCE <br />ADDL <br />INSD <br />SUER <br />wvD <br />POLICY NUMBER <br />P LI Y <br />MMlDDIYYYY <br />IC EXP LIMITS <br />MWDD <br />X COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE $ 3,000,000 <br />CLAIMS -MADE CI OCCUR <br />` <br />PREMISES Ea occurrence $, 100,000 <br />- <br />I <br />MED EXP (Any One person) S 5,000 <br />A <br />X <br />EOL9322020-11 <br />01/02/17 <br />01/02/18 PERSONAL &ADV INJURY $ 3,000,000 <br />X ERRORS & OMISSIONS <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />5 000-000 <br />GENERAL AGGREGATE $ r r <br />X PRO - <br />POLICY ❑ JECTPRO ❑LOC <br />PRODUCTS - COMPIOP AGG $ 5,000,000 <br />OTHER: <br />$ <br />AUTOMOBILE LIABILITY$ <br />(0M111_1'1 61NULL LIMIT Ea acctd.'t <br />ANYAUTO <br />BODILY INJURY (Per person) $ <br />ALL OWNED SCHEDULED <br />BODILY INJURY (Per accident) $ <br />AUTOS AUTOS <br />NON -OWNED <br />ROPE $ <br />HIRED AUTOS AUTOS <br />idenfpAMAGE <br />I <br />5 <br />UMBRELLA LIAB <br />CC CUR <br />EACH OCCURRENCE $ <br />EXCESS LIAB <br />CLAIMS_MADE <br />AGGREGATE $ <br />S <br />DED I RETENTIONS <br />WORKERS COMF'cNSATION <br />- <br />ST.CTIJTE ER <br />AND EN,.PLOYERS' UABiU i , YIN <br />ANY PROPRIETORlPARTNERIEXFCU71VE <br />EL. EACH ACCIDENT $ <br />OFFICERIMEMBER EXCLUDED? <br />❑ <br />N!A <br />(Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYE *$ <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule. may be attached if more space is required) <br />CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES, AND VOLUNTEERS ARE INCLUDED AS AN <br />ADDITIONAL INSURED WITH RESPECTS TO THE OPERATIONS OF THE NAMED INSURED IF REQUIRED BY <br />WRITTEN CONTRACT OR WRITTEN AGREEMENT. <br />r.FRTIFICATF Hnl nFR CANCELLATION <br />CITY OF SANTA ANA <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ATTN. RISK MANAGEMENT M-28 <br />ACCORDANC WITH THE POLICY PROVISIONS, <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92701 <br />f <br />AUTHORIZE RE ESE77V. <br />01 2014 ACORD CORPORATION. All rights reserved. <br />ACORD25(2014/01) The ACOiRD name and loco are reciistered marks o CORD <br />