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CERTIFICATE OF LIABILITY INSURANCE
<br />DA76- (MMIoonrYYYI
<br />1012612016
<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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If rtiflcate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject` "o
<br />the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to thili• -
<br />certlficate holder In lieu of such endorsoment(s).
<br />PRODUCER
<br />CuTAOT Christine Sousa
<br />BAKER ROMERO & ASSOCIATES INSURANCE BROKERS, INC.
<br />PHO
<br />(626)332.2258 FAx (626) 339-9921
<br />EMAIL christine@bakerromero.cam
<br />a9p�Ess:
<br />760 TERRADO PLATA SUITE 238
<br />tNSURER(S) AFFORDING COVERAGE
<br />MAIC 0
<br />COVINA CA 91723
<br />Agency LlcA:0G22780
<br />INSURER : United States Liability Insurance Co
<br />INSURED
<br />-
<br />-----
<br />CENTRO CULTURAL DE MEXICO EN EL CONDADO DE ORANGE
<br />INSURERS
<br />P.O. BOX 133, SANTA ANA, CA 91702
<br />313 BIRCH STREET
<br />INSURERC
<br />SANTA ANA CA 92701
<br />INSURER 0:
<br />INSURERE
<br />INSURER
<br />VERAGES CERTIFICATE NUMBER: 15356 REVISION NUMBER:
<br />VIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE PO OD
<br />�IElDICATED, NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT NTH RESPECT _'C3-_Wk0F_{i1�4}I( '
<br />LqERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO �E�LTJ�T�141ES
<br />CLUSIONS AND CONDRIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />INSR
<br />TYPE OF INSURANCE
<br />ADOL
<br />SYS
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXPlam
<br />10/26/17EAOHOccuRRENCE-1,000;000
<br />-qf
<br />X COMMERCIAL GENERAL LIABILITY
<br />NPP1668111A
<br />10/26/16
<br />'h"
<br />CLAIMS -MADE [k]OCCUR
<br />PR�BEeOR NTRID Yri$•'• 100,000
<br />MED, EXP (My one person) u
<br />PERSONAL. & ADV INJURY $ 1,000,000'
<br />F, r
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE 5FITy 4, 00,000,
<br />_
<br />PRO-
<br />POLICY ❑ ❑ LOC
<br />PRODUCTS -COMPIOP AGG 8 included
<br />,.
<br />JECT
<br />OTHER:S
<br />4 --
<br />-- -�
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />(Ea aoddanl) $
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />BODILY INJURY (Per parson) $ r — --- .• . -
<br />'
<br />AUTOS AUTOS
<br />BODILY INJURY (Pet accident)
<br />' 21
<br />HIRED AUTOS NON -OWNED
<br />AROPERTY DAMAGE $ '
<br />r A
<br />AUTOS
<br />(par acddenl)
<br />—_
<br />UMBRELLA UAB
<br />OCCUR
<br />EACH OCCURRENCE S �.-
<br />CQBXCBSa
<br />UAB
<br />CLAIMS -MADE HAGGREGATE
<br />$ _ -_ 3
<br />OED RETENTION
<br />±;37ATV7E
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />YIN
<br />ER T'•' -.� `•
<br />ANY PROPUMTORMARTNERIBXECUTNE
<br />E.L. EACH ACC(DENT
<br />rs
<br />OFFICERIMEMBER EXCLUDRD7
<br />NIA
<br />endalmylnNH) VE.L.
<br />DISEASE -EA EMPLOYEE.
<br />`
<br />DESCRIPTION ROF OPERATIONS Wow
<br />El. MSEASE-POLICY LIMIT 't
<br />�_ 1UfI,CI?C'
<br />e'
<br />s 1,01,U,UU(l
<br />,DESCRIPT:ON OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Scheduta, may ba attached if more Space Is required)
<br />The City of Santa Ana, Its Officers, Agents and employees named as Additional Insured but only with respect to Liability arising out,of the irlciU;.it,
<br />operations of the named Insured ,,,5pi;
<br />Addltlonai Insured Endorsement attached.
<br />%,ANt,=LA I IUN
<br />City of Santa Ana . � .- i r
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICES pE CANCELLEp.)3EF0RE
<br />.20 Civic Center Plaza, P.O. Box 1988 THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DI I IVIE4eISI'fN
<br />Santa Ana, CA 92702 ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />Attention:: ;I ;: l;,:ars,01 cr'r
<br />Lillian Romero -Gomez,
<br />ACORD 25 (2014101) ©1988-2014 ACORD CORPORATION. All,.r)ghts reserved,.
<br />The ACORD name and loco are recrlsterad markt of ACnRn
<br />I ��.Ili,vt5 I
<br />
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