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MMID <br />AC"Ro CERTIFICATE OF LIABILITY INSURANCE DATE /07/ 016 <br />l�°,,,,i 09/07/2016 <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 policy(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER CONTACT <br />Buckley & Associates Insurance Services, PHONE <br />_- <br />16651 Gothard Street, Ste. A-1 1AL&N4.EXtt (714)841-5830 IAIC Nola_ _ <br />Huntington Beach CA 92647 <br />INSURED <br />Stage Plus, Inc <br />C: <br />Po Box 11060 <br />Santa Ana CA 92711 <br />Ohio Security Ina Co <br />COVFRACFR CFRTIPICATF NI IIIIrart Tn 1401 RF\/I.RII NIIMRFR- <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 />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTRTYPE OF INSURANCE <br />ADDLHUBR <br />IND WVD <br />POLICY NUMBER <br />POLICYEFF POLICVEXP <br />MMIDD/Y YY - MMIDDM/W LIMITS <br />A X <br />ICOMMERCIAL GENERAL LIABILITY <br />Santa Ana CA 92702 <br />''. EACH OCCURRENCE $ 1,000,000 <br />CLAIMS -MADE X OCCUR <br />HZ367232478 <br />07/29/2016 DAMAGE TO RENTED <br />,07/29/2017 PREMISES RENTED <br />ncej. $ 1,000,000 <br />_ <br />MED EXP (Any one person) 5 10,000 <br />PERSONAL &ADV INJURY $ 1,000,000__ <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER <br />GENERAL AGGREGATE S 2,000,000 <br />X <br />PRO- <br />- - -- <br />POLICY .7] JECT LOC <br />PRODUCTS-COMP/OP AGG $ 2,000,000 <br />OTHER: <br />$ <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT 5 <br />(Ea accitlent) _ — — _ <br />ANY AUTO <br />BODILY INJURY (Per person) $ <br />OWNED SCHEDULED <br />AUTOS ONLY _ AUTOS <br />BODILY INJURY (Per accident) $ <br />HIRED NON -OWNED <br />Tr�*"y� _ <br />PROPERTY DAMAGE $ -- <br />AUTOS ONLY AUTOS ONLY <br />WYl d°° <br />W Per accident <br />.p1 <br />UMBRELLA UAB <br />OCCUR <br />EACH OCCURRENCE $ <br />EXCESS LIAB <br />CLAIMS -MADE <br />\11 <br />Cj AGGREGATE $ <br />DED RETENTION$AD <br />PPl~� $ <br />WORKERS COMPENSATIONORH <br />EMPLOYERS' LIABILITY1y <br />YIN������`" <br />ANVPROPRII ETOR/PARTNE EXECUTIVE <br />ACCIDENT <br />OFFICER/MEMBER EXCLUDED? <br />NIA <br />EL. EACH $ - -- <br />(ManaatoryinNH) <br />yyw` <br />E. L. DISEASE - EA EMPLOYEE <br />If yes, describe under <br />"0 <br />_$ <br />- <br />DESCRIPTIONOFOPERATIONSbelow <br />'', El.DISEASE -POLICY LIMIT $ <br />$ <br />$ <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />The City of Santa Ana, it's officers, employees, agents, and representative are named as additional <br />insured with respect to the General Liability as their interest may appear. Primary & <br />Non -Contributory wording applies. 10 days notice of cancellation due to non-payment of premium. <br />CFRTIFICATE HOLDER CANCFI I ATION <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />Page 1 of 1 <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 />City of Santa Ana <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92702 <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />Page 1 of 1 <br />