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/-1• CO ni®PATE <br />CERTIFICATE OF LIABILITY INSURANCE <br />pANJeoIyYYY) <br />TYPE OF INSURArICEWY <br />4/172015 <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 cortifloata holder is an ADDITIONAL INSURED, the policy(les) 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 />carlIfIcats holder In lieu of such ondorsoment(a), <br />PROOVCEft <br />CONTIAMEE Ci Dori ITaIed Ferranttl <br />Assistance Insurance Agency <br />PHONE (714)245_2777 FAX (110245.210 <br />.Uuc,tiv.kat' Alg.N.91' y. <br />13732 Newport Avenue ^ Suite 1 <br />eo REss; djaredeasaistanceins. com <br />INSURBRLS)AFPOROINC COVERAGE <br />NAICq_ <br />UNJA Lr��R NT€D <br />Mao EIRP IAO, doe person) <br />Tustin CA <br />INSURRRA:State Compensation Insurance Fund <br />^^GEN <br />1 'l <br />-92730 ._ - <br />INSURED <br />INSURER BI <br />_ <br />_s <br />bfanuel Huante, DBA; Stage Plus, Inc. <br />INSUPERCI _ <br />S <br />2330 S. Susan St. <br />INSURER 01�-.�T <br />'. <br />NSUREREI <br />AUTOMOBILE LIABW <br />ANY ALTO <br />ALL OWNED SCNEoot,w <br />AUTOS ❑ AUTOS <br />NON•OWNEO <br />HIRED ALT P6 AUTDB <br />Santa Are. CA 92704 <br />INSURER F' <br />RPV) Swed by' <br />COVERAGES CERTIFICATE NUMBER:15-16 WC 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. NOTWTHSTANDINO 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 CONOIVONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ILS <br />TYPE OF INSURArICEWY <br />ATYDL'ISUSR'"""""` <br />POLICY NUMBER <br />PO�IOYEPF <br />—POLICY San <br />LIMITS <br />COMMERCIALGENERALLABILITY <br />CLAIhIS AlADE l OCCUR <br />1' <br />i <br />EACH OCCURRENCE <br />S <br />UNJA Lr��R NT€D <br />Mao EIRP IAO, doe person) <br />'3 <br />S <br />^^GEN <br />1 'l <br />^_ <br />PER40NA4 4 AOV INJURY <br />S <br />'I. AGGREGATE LIMIT APPLIES PER; <br />1R1, <br />IPOUCY u JECTPRG• [] LOC <br />OTHER: <br />GENERAL AGGREGATE <br />S <br />PRODUCTS-COMPICPAGG <br />_ <br />S <br />S <br />AUTOMOBILE LIABW <br />ANY ALTO <br />ALL OWNED SCNEoot,w <br />AUTOS ❑ AUTOS <br />NON•OWNEO <br />HIRED ALT P6 AUTDB <br />Idlaonl <br />RPV) Swed by' <br />C(MBINEDTY EINGL LIh11T <br />S <br />ROPILY INJURY (Par paroan) <br />9 <br />BODILY INJURY (Par acr,Uanq <br />S <br />Pft�Pal'rC1Y 0A�ih AC•� <br />_lYaL4P914S!�. <br />S <br />UMSRELLA LIAR <br />I Excess UAa <br />Doc UR <br />CLAIM4-uADE <br />I •n <br />pRGSAIAdm <br />EACH OCCURRENCE <br />S <br />,AGGREGATE <br />9 <br />DED I I RETENTION S—� <br />A <br />WORMERS COMPENSATION <br />ANO EMPLOYERS' LIABILITY <br />-ANY PROPRIETOWPARTNERIEXECUTIVE YIN <br />OFMCER/MEA18CR LXCLUOEOP <br />IManGatory In NH) <br />If BS. dascrlhaurldee <br />0 SGRIPTI N OF OPERATIONS W. <br />NIA <br />110631E-15 <br />5/1/2015 <br />5/1/2030 <br />R PTA T ETH^ <br />i <br />E.L. EACH ACCIDENT <br />S 1,Oa0,oao <br />E.I. DISEASE. EA EMPLOYE <br />S L, 000 A0q <br />EL DISEASE • POLICY LIMIT <br />S 1 000 000 <br />DESCRIPTION OF OPERATIONS I LOCATIC NS1 YENICL IS (ACDRO 101, A041114011 Ramarka Sandaula, may be acaa1IPU Irmare spade Ie raquima) <br />The City of Santa Ana, ita officers, employees, agents, volunteers and representatives <br />Proof of Insurance <br />The City of Santa Ana <br />RRCSA <br />20 Civio 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 PROVISIOI <br />reserved. <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />INS025120140n <br />