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a� a® CERTIFICATE OF LIABILITY INSURANCE <br />009103/2015 1 <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 />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 INSURERS), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the <br />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 />CONTACT <br />PRODUCER <br />KEN INOUYE INSURANCE AGCY INC NAME: DANIELLE DAVIS <br />STATE FARM LIG # OD12117 PHONE <br />.562-865-5228 me op 562-865-3534 <br />EMAIL <br />Statefarao 11010 ARTESIA BLVD AooREss_DANIELLECo1KENINOUYE.COM_. <br />CERRITOS, CA 90703 INSURERISLAFPORDINGCOVERAGE NAICN _ <br />INSURER A: State Farm Fire and_Casualty Comoanv 25143 J <br />INSURED IMPRENTA COMMUNICATIONS GROUPING .INSURER B: State Farm Mutual Automobile Insurance Com an 2.5i7a <br />300 S RAYMOND AVE STE 9 INSURER c <br />PASADENA, CA 91105 INSURER D: <br />INSURER E: <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 REOUIREMENT, 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 />)NSR <br />LTR <br />I' <br />1 TYPE OF INSURANCE <br />AOOLS� <br />POLICY NUMBER <br />POLICYEFF <br />MMIDDIYYW <br />POLICYE%P <br />MMIDDIYIYY <br />LIMITS <br />A <br />LGENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />Y 92-84-KOOS-3 <br />02/02/2015 <br />02/02/2016 <br />EACHOCCUR9_N7E <br />$ 1,000,000 <br />_ <br />PREMISES EaU,ccunce <br />$ <br />MEO ESP (my one person) <br />$ 5.000V <br />III <br />CLAIMS-MADE'XJ OCCUR <br />PERSONAL B ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GENL AGGREGATE LIMIT APPLIES PER. <br />PRODUCTS - COM PIOP AGO <br />$2,000,000 <br />X POLICY PE : LOC <br />$ <br />g AUTOMOBILE UAOILITY <br />y <br />471 5490-E20-75 <br />05/20/2015 <br />COMBINED SINGLE LIMIT <br />05/20/2018 (Ea acciwntl'. S 1,000,500 <br />X ANY AUTO <br />BODILY INJURY (Per person) IS <br />ALL OWNED SCHEDULED <br />AUTOS 'X AUTOS <br />y HIRED AUTOS X NON -OWNED <br />AUTOS <br />BODILY INJURY (Per accident)' <br />$ _ <br />-'PR6PERTY-DAMAGE <br />(Per eccldentl $ <br />UMBRELLA LIAR <br />OCCUR <br />! <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTIONS <br />_ <br />$ <br />'A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' UABIUTYYIN <br />ANY PROPRIETOR/PARTNERIEXECUTIVE <br />OFFIODMEMBER EXCLUDED? <br />(Mandatory In NH) <br />NIA <br />92-CG-KS32-8 <br />92-EB•660;1.0 <br />10126/2014 <br />10/26/2015 <br />10/26/2015 <br />10/26/2016 <br />VICSTATU- X'OTH - I <br />TORY LIMITS I Eft <br />IE.L EACH ACCIDENT ��$ 1,000,0011 <br />" <br />I E.L. DISEASE- EA EMPLOYEE, $ t 000,5oo <br />E.L. DISEASE P tIMIT j $ 1,000,000 <br />If yea, tl¢Scrt. undor <br />nPSCRIPTION OF ORER8TIONS balmj <br />I <br />Ll <br />1 <br />DESCRIPTION OF OPERATIONS I LOCATIONS) VEHICLES (Attach ACORD 101,Add!denaI Remarks Schedule, if more space is requlredJ S <br />LOCATIONS: City of Santa Ana ,r+ueJ <br />Certificate holder, its officers, agents, and employees are named as Additional Insured in regards to General Li <br />"10 -days notice of cancellation for nonpayment.QR.G`� <br />Should any of the above described policies be cancelled before the expiration date thereof, the issuing Insurer will mull 30 -days written notice to the certificate <br />holder named below. <br />City of Santa Ana <br />Attn: PRCSA <br />20 Civic Center Plaza - M - 23 <br />Santa Ana, CA 92701 <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 />AUTHORIZED REPRESENTATIVE <br />All rights reserved. <br />ACORD 25 (2010/135) 1 he AUOKU name and logo are registered marKS ar AULIKU 1001486 132849.8 01-23-2013 <br />