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,4c"oRn CERTIFICATE OF LIABILITY INSURANCE
<br />DAN ,MM OayvY .-..
<br />`
<br />08/1812016'
<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 be endorsed. If SUBROGATION IS WANED, 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 />cerUffeste holder In lieu of such endomement(s)•
<br />PRODUCER
<br />CONTACT Christine Sousa
<br />BAKER ROMERO & ASSOCIATES INSURANCE BROKERS, INC.
<br />P n M, 626) 332.2258 P �. (626) 339-9921
<br />E'MA'L christine@bakerromero.com
<br />7.80 TERRADO PLAZA SUITE 238
<br />INSURER(S) AFFORDING COVERAGE
<br />COVINA CA 91723
<br />MUKRA : United States Liability Insurance Co
<br />Agency Lich: 0642790
<br />INSURED
<br />CENTRO CULTURAL DE MEXICO EN EL CONDADO DE ORANGE
<br />—
<br />INSURERS
<br />INSURERS
<br />P.O. BOX 133, SANTA ANA, CA 91702
<br />313 BIRCH STREET
<br />INSUNERD:
<br />SANTA ANA CA 92701
<br />INSURER E
<br />IS
<br />,COVERAGES CERTIFICATE NUMBER: 15031 REVISION NUMBER:
<br />. ,PHIS IS TOCERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOWHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIO OD
<br />(INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO Wtil9 ZffiISHIS
<br />CGERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLT,IjlETFftyCIES
<br />CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />IM
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUM
<br />pOVCY NUMBER
<br />PCUCYEFP
<br />PoucYevWID
<br />LIMIT9
<br />X COMMERCIAL GENERAL LIABILITY
<br />NPP1668111
<br />10126MS
<br />10/26/16
<br />EACH OCCURRENCE'sl— , D-,100
<br />III(CLAIMS-M,WE
<br />I�OCCUR
<br />MEM( PREMISETOREMEOS sxwenm) $ 100,00
<br />cal
<br />AND. EXP (Arty one psrson) _$_ _, 5,009
<br />P7171
<br />,
<br />PERSONAL&ADV INJURY S , 1,000,000
<br />BBA.
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE�� ' QQ,000�
<br />- r
<br />1.75'
<br />PRO-
<br />POLICY 0JECT F1 LOC
<br />PRODUCTS •COMP/OP AGO $ included
<br />OTHER:
<br />y�
<br />AUTOMOa1LP
<br />IJA91LnY
<br />COM aSINGLE DMR
<br />IFS ecdEmll $ -
<br />ANY AUTO
<br />BODILY INJURY (Per person) $
<br />ALL OWNED SCHEDULED
<br />BODILY INJURY (Per Soadem) S
<br />AUTOS
<br />HIREDAUTOS NON-0WNED
<br />_
<br />PROPROPERTY DAMAGE $
<br />AUTOS
<br />LBOM
<br />$
<br />ua uR LNa1
<br />OCCUR
<br />EACH OCCURRENCE S _. _._.... ,
<br />"me ILIAD,
<br />CLAIMS-MADE
<br />AGGREGATE S —
<br />DED I RETENTIONS
<br />$ ' :r!D
<br />41-
<br />'I^
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' IMBILnY
<br />PER OM .J
<br />STAnRE ER
<br />ANY PRaPRIETOMPARTNEn1E11ECN1ME YIN
<br />ExcwoEnr 1
<br />aMemdaIyin
<br />E.1- EACH ACCIDENT S 1
<br />E.L. DISEASE-EA EMPLOYEE S
<br />.F*•
<br />IMan4le,y In Nle
<br />NIQ
<br />Nlp
<br />IOPscRI�Pnorr OF OPERATIONS Ceba
<br />E.L. DISEASE-POLICY LIMB $"
<br />o 100,000,1
<br />�T AUDI
<br />1,000,000
<br />c96SCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be aMached If nes Space Is required) '"` •'' 52;000,0001
<br />j;The City of Santa Ana, Its Officers, Agents and employees named as Additional Insured but only with respect to Liability arising out of the, included
<br />operations of the named insured �_
<br />Additional Insured Endorsement attached.
<br />. CERTIFICATE HOLDER CANCELLATION :I
<br />I
<br />City
<br />CI of Santa Ana
<br />` r,,.._. "
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ..-I
<br />20 Civic Center Plaza, P.O. BOX 1968
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVEREDiI IN'.1
<br />-^' Santa Ana, CA 92702
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />:.., :;..
<br />AUIHORI7FA REPREEEMAIPJE '
<br />I
<br />Attention:1
<br />Lillian Romero-Gomez
<br />;a;.nDci
<br />ACORD 25 (2014101) p 1988-2014 ACORD CORPORATION. All rights reserve On;
<br />The ACORD name and logo are registered marks of ACORD .,
<br />'Y . aac.ord,
<br />
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