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A� O CERTIFICATE OF LIABILITY INSURANCE <br />ATE <br />004/18/2016 ) <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 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 />PRODUCERN <br />KEN INOUYE INSURANCE AGCY INC <br />STATE FARM LIC # OD12117 <br />5Pa3eFarm 11010 ARTESIA BLVD <br />NACOME'TACT DANIELLE DAVIS <br />PHONE Fax <br />c,.Ny.ErdP 562-865-5228 Nc,,tlol: 562 -866 -35.Z4 --- <br />E-MAIL <br />Doaasa; DANIELLECu1KENINOUYE.COM <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />Y <br />CERRITOS,CA90703 <br />NSURERIS)AFFORDINOCOVERAOE <br />NAICq_,__ <br />INSURER A: State Fann Fire and Casu@II�Com an?419.._... <br />EACH OCCURRENCE <br />INSURED IMPRENTA COMMUNICATIONS GROUP INC <br />INSURER .:State Farm Mutual Automobile lnsurencB Company <br />2Si70 <br />INSURER C: <br />_ <br />300 S RAYMOND AVE STE 9 <br />CLAIMS-MAOE XZ OCCUR <br />PASADENA, CA 91105 <br />INSURER O: <br />PERSONAL &ADV INJURY <br />$ <br />INSURER E: <br />_ <br />INSURER F <br />COVERAGEQ r1ERTHTlrATF 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 />R <br />TYPE OF INSURANCE <br />DOL <br />POLICY NUMBER <br />PMIOIb4eYYY <br />MMOOPflxVY <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />Y <br />92 -B4 -K006-3 <br />02/02/2016 <br />02/02/2017 <br />EACH OCCURRENCE <br />5 2,000,000 <br />PREMISES Ee occurrence <br />$ <br />MEDEXP(Anyaneperow) <br />_ <br />$ 5,000 <br />CLAIMS-MAOE XZ OCCUR <br />PERSONAL &ADV INJURY <br />$ <br />_ <br />u <br />GENERAL AGGREGATE <br />$ 4,000,000_ <br />GEN'LAGGRECATELIMITAPPOESPER: <br />PRODUCTS - COMPIOP AGG <br />$ 4,000,000 <br />If <br />X1 POLICY <br />PRO D LOC <br />AUTO MOBILE LIABILITY <br />Y <br />4715490-E20-75 <br />05/20/2015 <br />05/20/2016 <br />COMB <br />Ea awldent) NED SINGLE LIMIT <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />X ANY AUTO <br />BODILY INJURY (Peraccitlenq <br />$ <br />X X SCHEDULED <br />AUTOS UTOS <br />NON -OWNED <br />HIRED AUTOS X AUTOS <br />PROPERTY DAMAGE <br />IPeraccideni <br />$ <br />5 <br />UMBRELLA LIAR <br />OCCUR <br />EACHOCCURRENCE <br />S <br />AGGREGATE <br />$ <br />EXCESS LIAR <br />CLAIMS -MADE <br />DEO RETENTION $ <br />$ <br />A <br />WORK ERS COMPENSATION <br />ANDEMPLOYERS'WASILITY YIN <br />ANY PROPRIETORIPARTNEMEXECUTIVE <br />92 -EB -8603-0 <br />10/26/2015 <br />10/26/2016 <br />X wC BTATU- X OT1----- <br />E.EACH ACCIDENT <br />L. <br />$ 1,000,000 <br />E.L. DISEASE. EA EMPLOYEE <br />$ 1,000,000 <br />OFFICE/MEMBER EXCLUDED? ❑ <br />IMandalory In NH) <br />NIA <br />❑ <br />E.L. DISEASE POLICY LIMIT <br />$ 1,000,000 <br />If yes, desarlbe under <br />❑ <br />❑ <br />eday°. <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addlllonat Remark. Schedule, If Moro apace ie required) <br />LOCATIONS: City of Santa Ana <br />Certificate holder, Its officers, agents, and employees are named as Additional Insured in regards to General Liability. <br />'10 -days notice of cancellation for nonpayment. ^�\\Jr^�j <br />Should any of the above described policies be cancelled before the expiration date thereof, the Issuing insurer will mall 30-daySr lsD Lice to the certificate <br />9^" <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 />REPRESENTATIVE <br />TION. All rights reserved. <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 1001406 132049.8 01-23-2013 <br />