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'I I LIABILITY INSURANCE DATE( k'oDNvyy) <br />. 08-08-2016 <br />THIS CER-RFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE C RTiFICATE 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 INSURERS}, AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the cortfilcato holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed, If SUBROGATION IS WAIVED, subject to <br />Me terms and conditions of the POIICy, certain pollcle . may require an endorsomoRt. A statement on this certificate dons not confer rights to the <br />cortificate holder In Ilea' of such ondorsomontla). <br />PRODUCER CONTACT Ignacio Rabe <br />POMONA INSURANCE AGENCY PHONE 909-623-3202 ,�; 9®9-623a1340 <br />478 IN HOLT AVE DDRE <br />—INSURERS AFFORDINO COVERAGE NAILS. <br />POMONA CA 91768-3601 INSURER A! Ccvi[i (Call S eCialt ll�o Ca <br />INSURED LNSURpLe; <br />Jorge Cervantes Jrm°" LNStIRERc: <br />DBAT ,Audio Video DO',B � `rr. <br />INSURER D <br />6002 Muller Street INSURERE <br />Fell Gardens CA 90201 rNSURER F; <br />i1nVFPAIIFQ r1F0 TI4,f°A,rF Kit 19110rp. f3CAlle[ner mlluca Ct7. <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE 13EEN ISSUED TO THE INSURED NAMED ABOVE, FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTWTH 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 />CU—S <br />TYPE OFINSU ANCIr• <br />ADDL. <br />e'R <br />lm <br />POLICY N MRER <br />POU EFF <br />1) <br />POLICYE%P <br />JmWa2mm <br />LIMITS <br />COMM91LCLA.LGENERALUAaILITY <br />CI.AIMS•btr.rtE OCCUR <br />Dp <br />f}S,feS/ICIB <br />p8/CEi/2CiT <br />EACH OCCURRENCE <br />2BgMjVHA�47'96®3 <br />} �. RENTED 'rj <br />I 11000100D <br />1,m.0t)4, 000 <br />MEOEXP axe <br />s 91000' <br />_ <br />PERSONALB.ADVINJURY .. <br />$ ., 1,000,000. <br />GENT. AGGREGATELIWAPPUEiSPER: <br />POLICY; �o ❑LOC <br />GENERALAGGREGATE <br />$ 2,00a,000 <br />PRODUCTS-COMEmPAGG <br />S 2,IID ,D00 <br />OTHSR: <br />AUTOMOBILE LIABILITY <br />COMHINEo SING Li % <br />ni <br />x <br />BODILY INJURY tPer peraonl <br />S <br />ANY AUTO <br />ALL MUZO SCHEDULEDAUTOS <br />NONG' 4f�}1A1 FO <br />HIREOAUTOSS AUTOS <br />.�,'� <br />I <br />BODILY INJURY (Pea ateiaenL) <br />5 <br />PROPERTY DAMAGE <br />J Cll_ <br />....» <br />$ <br />LIM RE"1IAB <br />EXCESSUae <br />OCCLiR <br />GLAIM5MMADE <br />'��.\K.,M... <br />kV+" <br />� `�_.. <br />EACH OCCURRENCE <br />AGGREGATE <br />3 <br />S <br />Leo REiEttTLgNS <br />S <br />WOFWXM COMPENSATION <br />ANO EMPLOYERS' LIA8mtTY <br />OFFICE�EEYO EARTNd ECUTYUE YI'" I <br />(Mandatory In NH) t " I <br />II ea, dosolbrl under <br />C,RIPItCtN 6F OPERATION$ taltawa <br />NIA <br />a _ <br />4 J <br />R N <br />I <br />EL.PACtiACGLf7ENT <br />5 <br />E.L. DISEASE - EA EMPLOYE <br />S <br />E.L. eISE.ASE -POLICY LIMIT S <br />DESCRIPTION OF OPERA..TIONBt LOCATIONS IVSHIOLS'S (ACORD 96I, Addldanot Remarks Sohoduto, may W attaahod It moan apart is mqulmd) <br />City of Santa. Asia, its officers, agents, employees and volunteers are included <br />as additional insured with respects to General Liability per the attached <br />endorsement its accordance with the terms, conditions,and exclusions of the <br />policy, as respects: Senior Dance held at Santa Ana Senior Center an 48/12/2Q16. <br />City of Santa Ana Parks, Recreation & Community SHOULD ANY OF THE ABOVE DI <br />Services Agency THE EXPIRATION DATE THE <br />g y ACCORDANCE IMiTH LIC <br />Attnt Gerardo Houet, Executive Director <br />20 Civic Center Plaza AUTHCYREZEDREPWIENTATI <br />Santa Ana, CA 92701 <br />(D i i88-2014 A <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />Be CANCELLED BEFORE <br />LL BE DELIVERED IN <br />rights reserved.. <br />