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CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DDNYYY) 4/14/2016 THIS 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 CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CE Iy IFIC' 1{�lQDER IMPORTANT: If the certificate holder is an ADDITI A LINSUR , tHlf 1611dy(ie 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).. " y }c: r .. - PRODUCER 1 ,A United Agencies, Inc. ,L 1�1 One Post, Ste. 200 Irvine CA 92618 CgNTA;.T NAME: ada PHONE FA% - - A Nat: E -MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC If 60475294 INSURER A: United 'r 4/6/2017 EACH OCCURRENCE INSURED DEKRI N D -01 INSURER B X COMMERCIAL GENERAL LIABILITY INSURERC: Dekra -Late Industries, Inc. 3102 W. Alton Ave Santa Ana CA 92704 INSURER D A E T Ea oc currence) oc ED PREMISES $1170,000 MED EXP tAn y one person) $5,000 INSURER E : CLAIMS -MADE IX I OCCUR INSURER F: COVERAGES CERTIFICATE NUMBER: P34359gaR REVISION NUMBER- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE 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 ADDLSUBR INSR me POLICVNUMBER POLICVEFF MMIDDNYYV POLICY EXP MMIDONYYY LIMITS • GENERAL LIABILITY 60475294 4/8/2016 4/6/2017 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY A E T Ea oc currence) oc ED PREMISES $1170,000 MED EXP tAn y one person) $5,000 CLAIMS -MADE IX I OCCUR PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,00D,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP ADD $2,000,000 POLICY PRO- LOC $ • I AUTOMOBILE LIABILITY 60475294 4/8/2016 4/8/2017 COMBINED SIN7D!T7VT_ Ea accident $1,000,000 BODILY INJURY (Par person) $ X ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X NO%OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident $ Leased /Rented Autos $ACV • X I UMBRELLA LIAR OCCUR 60475294 418/2016 418/2017 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 EXCESS LAG CLAIMS -MADE DED X RETENTION$ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN N WC STATU- OTH- 1 E.L EACH ACCIDENT $ ANY PROPRIETOR/PARTNEWEXECUTIVE❑ OFFICE RIMEMBER EXCLUDED? NIA EL. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESC RIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is requlr.d) The City of Santa Ana , its officers, elected or appointed officials, employees, agents and volunteers are to be specifically named and covered as Additional Insureds by the attached forms, but only as required by written contract with the named insured prior to an occurrence, Subject to all policy terms & conditions. Re- Ili1ew C.69 6 City of Santa Ana 20 Civic Center Plaza Santa Ana CA 92701 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 no 1988 -2010 ACORD CORPORATION. All Hrthts ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD