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1CCiIYC1" CERTIFICATE OF LIABILITY' INSURANCE 'io%'z%zoiYs� <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 ho endorsad, 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 endorsomentfsf. <br />PRODUCER _. <br />QUALITY PLUS INSURANCE AGENCY, INC. <br />1450 N 17USTTN AVE <br />STE 221 <br />SANTA ANA CA 92705 <br />-- <br />INSURCO <br />RAMIREZ, PRODUCTIONS <br />931 W,CHESNUT AVE <br />"14 245 1200 —FAX <br />714-245 -1201 <br />,tiIL E tL7_ __. 1A/c, NPI <br />E MAIL <br />AODREss gualltyplus2009@glilai.ccam <br />_INSURERM AFPOaD!NG COVERAGE NAIL% <br />NSURERA:.ONITED SPECIALTY INSURANCE COMPANY <br />"SURER U. <br />NSURER C: <br />INSURER 0: <br />SANTA ANAINSURER E: _ <br />CA 92703 ,INSURER F. <br />_—. <br />COVERAGES r•honclrn ry Mun*ncn. <br />THIS IS TO CER ITPY I1AT THE POLICIES OF INSURANCE LJSI'FD BELOW FIAVE 13CEN ISSUED TO THE MSURED NAMED <br />ABOVE F'OR I'HE POLICY PER'CD <br />ND GATED NOTWI Tf ISI'ANDIWO ANY REQUIREMENT. TERM OR CONDITION Of ANY CONTRACT ON O''HER DOCUMENT WITH RESPECT TO WHICH THIS <br />-ERTWICATE MAY HE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL <br />C.4- TERMS <br />EXCLUSIONS AND ONDtTIONS OF SUCH PO1: CIT 8, LIMITS SHOWN MAY HAVE? REEN REDUCED BY'°AID CLAIMS <br />ILEA -- - A001.SUOR _--- - VOLICY EFF PbLICY EXT''- - - <br />LTR TYPE OF INSURANCE POLICY NUPAFF.R IMM14eDIYVW g4Mlell/YYVY) LIMI"a <br />OCNERAL Llae11JTY FACHOCC..LRRENCE > <br />USA4104247 10(21/15 7.0/21/16 DAMAOFITR[:NTPO -'- <br />✓ CCMMERCIAL AL LIABILITY <br />1,000,000 <br />PREMISES (ap c4m0 xat _. S <br />AIMS <br />AIMS41ADE <br />100,000 <br />ClCI -MAO[ OCCUR MED eXP (Any anm eursm'1 4 <br />5, 000 <br />__ <br />A PERSONAL &ADV INJURY S <br />1,0_00,000 <br />OPNF RAI AGGREGATE <br />21000,00D <br />.S <br />AGGREGATl: 11MtT APPI IFS PLR PRODUCTS COMPIOPAGO 3 <br />1.1000,000 <br />P2i_, LOC.- <br />��— <br />AUTOMOBILELIABiLITY COWDMEp'iIN4LE LIMit—"—""�— <br />ANY AUTO R, OILY INJURY(P•v M tab, S <br />ALTOWNED SCHEDAUrOSULEI: Reviewed by -— <br />AUTOS DOOILY INJURYIP9r 8,140,10 S <br />.G <br />NON <br />"IRLDAUTOS Ap SUNIF:O PRCT�T33V OAMPGG e <br />_jFgf 9ccdwl _ <br />5 <br />UMBRELLA LIAR OCCUR I � [Ai:d OCCURRENCE S <br />EXCESS LIAR L'IAMS.MaUL // AO('RECwTE. <br />WORKERS COMPENSATIONM5.v STAiU� OT4L <br />{/^�, Ai� <br />AND EMPI..OYERS' LIABILITY Acosta Eft <br />YIN "carmen � �IQFY- -- <br />ANY PROPRIETOR,PARTNFRB%ECUTNE _1 FACII ACCIDENT S <br />OM.TCEIknIMBER E%CLaAEO, iJ NIA PRCSAfRecreatian <br />n In M1I F L DISEASE EA EMPtEYEE S <br />'I Y Je3r _.. <br />iI-SC <br />IPTJONun4et <br />f}ESCRIPiION OF OPF.khTIONS balpx_EL DISEASE �POL,CY L.MIP 5 <br />__— _ _ <br />DESCRIP TION OF OPERATIONS I LOCATIONS /VEHICLES (M1HaeN ACOfEU 10i, Atl4iewal Remar&s $c6e4Uh, if nwiP space Is ro4uim41 <br />`AU0K0,VIDEO,T.t4XT1N0.90UNM' <br />***Certificate Holder,its officers,agents,and employees are named as <br />additional insureds to General Aiability per form CG20.10 <br />**'*10 Days notice Of Cancellation For Non Payment Of Premium*** <br />City of Santa Ana <br />Attn:Purchasi.ng Department <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 DE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />©t <br />ACORU 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />reserved. <br />