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A� a CERTIFICATE OF LIABILITY INSURANCE <br />°0811712+ o 6YY( <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($), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: It Ula certificate holder is an ADDITIONAL INSURED, the policylles) In be endorsed. It 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 endoraemen4(s). <br />PRODUCER <br />Eddie Quillares Jr. State Farm Agency <br />StateFarm 415 N Broadway <br />Santa Ana, CA 92701 <br />CONTA <br />NAME; Jasmine Quillams <br />PH E y.714 -ell -7150 FAx a.714-61T-Ti5a <br />'"l L q.jasmine.qulliares.k9bnstatafarm.com __ <br />NAICp <br />Stale Farm Mutual Automobile Insurance Company 2517a <br />INSURERA: .. <br />INSUReo —Paul <br />DBA Ramirez Productions <br />527 N. Fairview Street <br />Santa Ana, CA 92701 <br />INSURER a: <br />INSURERC: <br />-- <br />NSURERD: <br />INSURERE: <br />INSURER F:. <br />rveeT,eu•ATE Muueca.79-1ARn REVISION NUMBER: <br />V 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 />i R <br />TYPEOFINSURANCE <br />- <br />POLICYNUMBER �IDORYYV <br />IMIDDAEX <br />LIMITS <br />COMMERCIAL 39NERAL LIABILITY <br />EACH OCCURRENCE S <br />a € <br />CLAIMS -WE G OCCUR <br />MEO EXP ars an s _ <br />PERSONAL &AOV INJURY € <br />GEN'L AGGREGATE. LIMpIT APPLIES PER <br />GENeRALAGOREOATE $ <br />I <br />PRODUCTS AGG s <br />POLIGY LOC <br />J�ECT <br />I <br />I <br />—.— <br />€ <br />OTHER' <br />A <br />AUTOMORMLIABIUTY <br />Y <br />Y <br />4891924 -C29 -75A 03129!2016 <br />09x29/2017 <br />Ea sea n L € <br />BODILY INJURY (Par "non) a 11000,000 <br />ANY AUTO <br />) <br />BODILY INJURY(PMAWdm0 L 1,000.000 <br />ALL OWNED x SCHEDULED <br />UUTppgg <br />AUTCE AUTO$ NEO <br />HIRED euros AUTOS <br />PUNINSURED <br />i <br />i <br />I <br />I <br />PROP T <br />Par I i 1.Daa,DDo <br />MTRIST S 30,000 <br />UMBRELLA LIAS <br />OCCUR <br />p eV,eW <br />EACH OCCURRENCE € <br />AGGREGATE € <br />EXCESS LIAR <br />CLAIMS ADE <br />6� <br />D I I R TENfIONS <br />€ <br />WORKERS COMPENSAVON <br />AND EMPLOYERS' LIABILITY YIN <br />OFFIGRRER PRE BORP,XCLUOEtl?ECUTIVE <br />OFFICE(MmdaWryld NHl <br />NIA <br />y' - y ` <br />E <br />ST T T ER <br />- <br />LEACH ACCIDENT S <br />EL. DISEASE -EA EMPLOYEES <br />EL DISEASE -POLICY LIMIT € <br />p yaa, deacnba under <br />DESCRIPTION OFOPERATIONS below <br />Carmel, l <br />Siecy at <br />on <br />DESCPJP RON OF OPERATIONS f LOCATIONS i VEHICLES (ACOAD ref, AddROnd RaeM10a sohadulo, may be am aea It nm. "0 N required) <br />Following Commercial Vehicles are Scheduled: <br />19971smuNPR-EFIBOXTrUCk JALC4BIK3V7006140 <br />City Of Santa Ana, Its Officers, Employees, Agents, <br />Volunteers and Representatives <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />ACORD 26 (2014101) The ACORD name and logo are <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 <br />"988-2014 XCD CORPORATION. All rights reserved. <br />Bred-RIO6so4 ACORD 1001486 132849.9 02-04-2014 <br />