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AC(:>R h® <br />1✓l.�/'w/./ CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMIDDN"Y) <br />1126/2016 <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 pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the 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 />PRODUCER <br />Paul Romero Insurance Agency <br />2869 Wanda Ave <br />Simi Valley CA 93065 <br />NAME: Paul Romero <br />PHONE <br />11, No Sao): 805-582-4655 (AIC, No): 805-581-3423 <br />ADDRESS: romeroins@aDLcom <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURER A: COLONY INSURANCE CO <br />INSURED <br />MAJOR LEAGUE INFIELD INC. <br />508 F- Chapman Ave <br />Fullerton CA 92832-2015 <br />INSURER B: MERCURY CASUALTY <br />38342 <br />INSURER c: REPUBLIC UNDERWRITERS INSURANCE CO <br />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 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 />LTR <br />TYPE OF INSURANCE <br />INSD <br />WVO <br />POLICYNUMBER <br />IMMJDD/YVYY <br />MM/DOIYYYV <br />LIMITS <br />A <br />✓ <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />X <br />101GLOO23266-01 <br />07/01/15 <br />07/01/16 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />E'TO'RENTE <br />PREMISES (Ea occurrence) <br />...'............. <br />$ 100,000 <br />MED EXP(Anyone person) <br />$ 5,000 <br />PERSONAL a ADV INJURY <br />$ 1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY C]JECOT El LOU <br />OTHER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />PRODUCTS - COMP/OP AGO <br />$ INCLUDED <br />$ <br />B <br />AUTOMOBILE <br />/ <br />y <br />" <br />y <br />LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />HIREDAUTOS �AU'OSWNED <br />X <br />BA040000019812 <br />VV VV�� <br />Y02/2016 <br />01/0212017 <br />CET! <br />(Fa am en"h <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />_ <br />$ <br />BODILY INJURY (Per are'dort) <br />S <br />(WrarcWent) <br />UMBRELLA LIAR <br />EXCESS LIAR <br />OCCUR <br />CLAIMS -MADE <br />f^ <br />1..J <br />�/dGj <br />EACH OCCURRENCE <br />3 <br />AGGREGATE <br />$ <br />CEO RETENTION$ <br />v _ <br />$ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOWPARTNERIEXECUTIVE YIN <br />FFICERIMEMBER EXCLUDED? ❑NIA <br />(Mandatory In NH) <br />If yes, descubn Under <br />DESCRIPTION OF OPERATIONS below <br />p'` I <br />r�p �ry �,!' <br />FlTW008812-00 C <br />LN <br />f^ <br />01I01I2016 <br />O'I/01/2017 <br />-OTFI:' <br />EA STAT UTF_ ER <br />EL EACH ACCIDENT <br />_ <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />S 1,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />"' <br />$ _ 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) <br />CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED AS RESPECTS TO THE OPERATIONS OF THE NAMED <br />INSURED. WITH RESPECT TO CLAIMS ARISING OUT OF THE OPERATIONS PERFORMED BY OR ON BEHALF OF THE <br />NAMED INSURED, SUCH INSURANCE AS IS AFFORDED BY THIS POLICY IS PRIMARY AND NOT ADDITIONAL TO OR <br />CONTRIBUTING WITH ANY OTHER INSURANCE CARRIED BY OR FOR THE BENEFIT OF THE ADDITIONAL INSURED. <br />10 DAY NOTICE FOR NON PAYMENT OF PREMIUM. <br />CITY OF SAN'TA ANA <br />ITS OFFICERS, EMPLOYEES, AGENTS AND REPRESENTA <br />20 CIVIC CENTER PLAZA <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 />)I KUKILLD KtYKtSGN I A I Pro <br />Pw.Af, R0FA,Ertr <br />©1988.2014 ACORD <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />All rights reserved. <br />