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I Chick here to clear —F--o-r-n--i] <br />[��fickhoro to Serid Fo=rrn <br />ACQRD,,, CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMtDDNYYY) <br />ADD"L <br />�NSR <br />12/29/2016 <br />PRODUCER <br />POLICY EFFECTIVE <br />DATElMMjDDjYyj <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />LIN ASSOCIATES INSURANCE AGENCY <br />—F7 <br />CITY OF SANTA ANA <br />ATTN: MARIO ESPINDOLA <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />24705 NARBONNE AVE, #200 <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />LOMITA, CA 90717 <br />$ <br />E� <br />DAMAGE TO RENTED <br />PREMISES EMnidne <br />INSURERS AFFORDING COVERAGE <br />. ....... . . . . . ......... <br />NAIL # <br />INSURED <br />MED EXP (Any one person) <br />PERSONAL & ADV INJURY <br />INSURERA: THE HARTFORD <br />INSURER B: <br />29459 <br />CENTURY STRUCTURAL ENGINEERING CO. INC. <br />24719 NARBONNE AVE <br />INSURER C: <br />LOMITA, CA 90717 <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY 0 PRO- ILOC <br />F <br />INSURER D: <br />$ <br />INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />.. .. . .......... ...... <br />INSR <br />LTR <br />ADD"L <br />�NSR <br />IYEF OF INSURANCE <br />---- ---- <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATElMMjDDjYyj <br />POLICY EXPIRATION <br />PATE IMMQDjYY) <br />...... . . .. <br />LIMITS <br />—F7 <br />CITY OF SANTA ANA <br />ATTN: MARIO ESPINDOLA <br />GENERAL LIABILITY <br />COMMERCtAl- GENERAL LIABILITY <br />r17 CLAIMS MADE IF7OCCUR <br />IMPOSE NO OBLIGATION OR LIABILITYK NP P–Q� 1 '46, THE INSU RER, ITS AGENTS OR <br />ANY <br />REPRESENTATIVES.,,"— <br />EACHOCCURRENCE <br />$ <br />E� <br />DAMAGE TO RENTED <br />PREMISES EMnidne <br />$ <br />MED EXP (Any one person) <br />PERSONAL & ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY 0 PRO- ILOC <br />F <br />PRODUCTS-COMPIOPAGG <br />$ <br />E7 <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />BODILY INJURY <br />(Per person) <br />BODILY INJURY <br />(Peraccident) <br />PROPERTYDAMAGE <br />(Peraccident) <br />E -I <br />GARAGE LIABILITY <br />i <br />AUTO ONLY -£A ACCIDENT <br />ANY AUTO <br />OTHERTHAN _EAACC.] <br />AUTOONLY: AGG <br />$ <br />— — — <br />�F <br />— <br />EXCES,SIUMBRELLA LIABILITY <br />OCCUR CLAIMSMADE <br />DEDUCTIBLE <br />RETENTION $ <br />F <br />EACHOCCURRENCE <br />$ <br />rr <br />AGGREGATE <br />$ <br />$ <br />r <br />$ <br />A <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR]PARTNERIEXECUTiVE <br />OFFICER/MEMBER EXCLUDED? <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />157WECDW3167 d <br />101118/2017IC <br />__j <br />STATU- I ]OTH <br />170RY"Um ER <br />E L. EACH ACCIDENT <br />$ 1,000,000, <br />57WECDW3167 <br />101/1812017 <br />F,L. DISEASE - F -A EMPLOY�E <br />$ 000,000 <br />F L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />CERTIFICATE HOLDER CANCELLATION <br />`,t� @ACOrA <br />ACORD 25 (200 1108) CORPORATION 1988 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />FOR EVIDENCE OF COVERAGE ONLY <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30- DAYS WRITTEN <br />PLANNING AND BUILDING AGENCY <br />NOTICE TO TRE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL <br />I <br />CITY OF SANTA ANA <br />ATTN: MARIO ESPINDOLA <br />IMPOSE NO OBLIGATION OR LIABILITYK NP P–Q� 1 '46, THE INSU RER, ITS AGENTS OR <br />ANY <br />REPRESENTATIVES.,,"— <br />AUTHORIZED REPREJIENTATIVE <br />LIN ASSOCIA-r <br />`,t� @ACOrA <br />ACORD 25 (200 1108) CORPORATION 1988 <br />