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TRESE -1 OP ID: BUMA CERTIFICATE OF LIABILITY INSURANCE D0 911 8120 11YY) �---'' a9r15rza15 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 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 PRODUCER INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS NAME7V Steve Falcon Falcon 6 Associates Insurance Services, Inc, PHONE FAX tAIC, No, Exq 323. 569.0760 (MC. Nol: 323. 669.0785 2615 Santa Avenue A X COMMERCIAL GENERAL LIABILITY EMAIL AODREss: stove @faisinc.com Commerce, CA 90040 DAMAGE ooa a�cE} s 100,06 Steve Falcon INSUREINS) AFFORDING COVERAGE NAICR PER L AGGREGATE I. IMIT APPLIES PER GENERAL AGGREGATE 1 61000,0 INSURER A: Colony insurance Company 39993 INSURED Tres Estrellas de Oro Inc. 01 HER INSURER a 1000 E. Santa Ana Blvd, #14 COMBINED SINGLE LIMIT $ IEa a.laent� ANY AUTO Santa Ana, CA 92701 ALL OWNED SCHELIUI.EU INSUREaC AUTOS AUTOS INSURER D. PROPERTY DAMAGE HIREOAUTOS AUTOS INSURER E INSURER F rnVPRArOFC CFRTIFICATF NIIMkFR, RFVIBInN NIIMRFR- 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 CCNDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ILTR TYPE DP INSURANCE ANDL W 0 POLICY NUMBER POLICY IDfYYYY MMIDCRYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 5,000,00 CLAIMSnMAOE X a:cuR X 101 GL 0026103 -00 0711612016 6771872616 DAMAGE ooa a�cE} s 100,06 MEDF%PiA,� T.Oereml $ 5,00 PERSONAL S ADV INJURY $ 3,000,00 PER L AGGREGATE I. IMIT APPLIES PER GENERAL AGGREGATE 1 61000,0 X POLICY JC` JEGT 1.00 PROOLICTS- COMPIOPAGG S 5,000,00 01 HER S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ IEa a.laent� ANY AUTO POOR INJURY (Per Pei eons I ALL OWNED SCHELIUI.EU E001LY INJURY I Pel acceenp a AUTOS AUTOS N GOWNED PROPERTY DAMAGE HIREOAUTOS AUTOS Pr,'acutlenll UMBRELLA LIAR OCCUR EACHOCCLCRESNCE c M. EXCESS LIA8 CLAIMS MADE. . AGGREGATE 5 DEC RE rEWIONS WORKERS COMPENSATION YFR OTH AND SMPLOYERS'LIABILITY YtN Si ATUTE ER AN' r— t --I P. i. EAGHACGIOENT 3 OFFICF,R{MEMH " ".LUUEG'C J WA L E)RML dtory In NH) -' It EL DISEASE EA EMPLOYEE $ .s O re5 dabcll DESCRIPTION N OF GF O PERHI'IONS PeIOw EL DISEASE POLICY LIMIT' .. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORO 101, Additional Rama AC Schedule, maybe attached a more apoce is requveUl ~ 'PLEASE SEE 2ND PAGE FOR ADDITIONAL INFORMATION REVIEWED BY: _. EUNICE HEREDIA {PG / OF,3 }. I The City of Santa Ana, It's Officers, employees 5. agents 22 Civic Center Plaza (M21) Santa Ana, CA 92702 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 r ZrI IQAA.2B1A ArnRn tnRPCIRATIn N. A11 dnfirn rwnwrvwd ACORD 26 (2014761) The ACORD name and logo are registered marks of ACORD