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DA rE M2H),Q M'XYYp <br />CERTIFICATE OF LIABILITY' INSURANCE, r_� 7 12/16 <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 IN'SURER(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 CONTACT STEVE SCHNEIDER <br />NAME. <br />SILVER CREEK, INSURANCE AGENCY PHONE 714-838-0693 rlrX 714-838-9438 <br />IMC, Ne, Ext): (AIC, No)} _ <br />17742 IRVINE BLVD SUITE 203 ADDRIESS' STEV @1SILVERCR EKAGENCY.COM <br />-_.. INSURERISI AFFORDING COVERAGE_ NAIL #Y.... <br />TUSTIN CA 42780 INSURERA: SENTINEL INSURANCE CO. . <br />INSURED INSU'RE-:R8, SENT INE L INSURANCE CO <br />WHITE NELSON DIEHL E'aVA.NS LLP INSURER C: <br />2875 MICHELLE, SUITE 300 -INSURER D <br />IRVINE, CA. 9,2606 IN>•IIRERE ....... ........ ......... ....... ........ __. ...._. <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTTFY TIIA'I° THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INMCATED, 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 />INS R ........ ._... . S ._.,.. �.. ADDL(841WVCi�r-..___........... � I'a0I_I(.Y YY 14'MiD Y EXE".S ..__ ..... <br />LTIi _�. ...TYPE CJE INSURANCE � POLI("''Y NIIMeErt-(tt4IdIDDIYYYYI MM1DOlYYYY1 LIMIT <br />GEGENERAL ErABII.ITY J EACH OCCURRENCE =5 1000000: <br />57SBA,BH5586 6/1/16 6/1/x1,7 DAMAGE IGRI NI[EIJ <br />CO s 300000 <br />CLAIMS MADE +� OCCUR i PREMISES ILa ncu.urr�nrrsp <br />�;ISI >e r�ir SAY o iA a .I MED EXII (Any ore person) �� 10000 <br />I - <br />A X PERSCNAI AADV INJURY s 1000000 <br />GENERAL AGGREGATE .i..S .:2000000 <br />,EhPLA c,REI;ATr:aRmIITALrEIRLaI=eER PRCIDUCI'S -GC.)MIP10PA7�rI I5 2000000 <br />PI ILIGY <br />._ .....___..L ............._,. 1C7C.._._..........m._..,..._.......r--...m...°._i...,. ..,..,...,.._....,,� ....._ ...,,.,.....,..w,_.............,._ � ,....__------. � ._.____ <br />AU'romOBILE LIABILITY 'jCC3Mt34NEl'.) SINGLE 1 RNm1a7 <br />� <br />57SBABH5586 6/1,/'16 6/1/17 I (Ea accident) 10000.00_ <br />ANY A07 I I EIOMI Y INA IRY ff'ier person ` $ <br />A ALLOWNED EI I RE DULI-D X RtaDiL Y INJURY pP'etr na odenll ; S <br />NON-d,T+NPdf=D PROPERTY DAMAGE ..� <br />H RED AUTOS � � ALHOS <br />UMBRELLA LAB ����p �� 157SB,A,BH5586 6/7./16 6/1/17 r ACH OCCURRENCE S 4000000 <br />A EXCESSLIAD CIS ms -MAIZE, X AGGREGAIF „5 4000000 <br />i DED _ HE"u NT'ION5 <br />WORKERS COMPENSATIONWf"�tp fIl@- <br />I- <br />ANDIMPIOYERSLIABILITY 57WEC'DX4233 6/1/16 G/1,/17 reIF2Y LIhIIT;a ER <br />AN`dI IIVE EL EACH ACCOEN II ° S 1000000 <br />B FFILE R/ IENIBE R EXCLUDED,, ,NIA _ <br />I <br />JIVIandatory InNR -._ EI UtSFASE EAEMPLOYEri_ 1000000_ <br />I e des,nbe: under - - <br />ury c;prlPrR(7hla;1 LE'E.Ia,�7luNtaEtelow EE. DISEASE °POUCYLIMIT E' l0 —00-9- <br />A <br />0A BUSINESS INTERRUPTION 57SBABH5586 6/1/16 1 6/1./17 ACTUAL LOSS SUSTA NETD <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schodute,,. it mores pace ins required <br />RE <br />'.Those usual to the insured"s operations. The City of Santa Ana, its officers, employees, agents, <br />volunteers and representatives are named as additional insured per additional insured form SS000080405 <br />attached to this policy. Business liability wavier of subrogation applies to the certificate holder <br />per form SS"000080405. Coverage is primary and non-contributory per the business liability coverage <br />form SS00080405. 30 day advanced notice of cancellation, 10 day notice for non-payment cancellation. <br />CERTIFICATE HOLDER . .CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE VI,IITH THE POLICY PROVISIONS,. <br />City of Santa Ana <br />20 Civic Center Plaza AUTHORIZE EIREPRFr ATIVF <br />Santa Ana CA 42701 f <br />1988-20'10 ACORD CORPORATION. All rights reserved <br />AC CORD 251201101051 The ACORD' nanne and logo are registers marks of ACORD <br />