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ACORO® CERTIFICATE OF LIABILITY INSURANCE <br />DAM(MMIDOIYYYY) <br />ik./ <br />1112912018 <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(ies) 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 <br />CONTACT <br />Alex Johnson CA License #OL58530 <br />Hall & Company <br />A/E Insurance Services <br />PHONE FMC,AX <br />. 360-626-2957 No: 360-626-2957 <br />nooARess: a ohnsongDhallandcompany.com <br />19660 10th Ave NE <br />9/20/2018 <br />POUIsbOWA98370 <br />EACH OCCURRENCE $1,000,000 <br />INSURERS AFFORDING COVERAGE NAIL$ <br />INSURER A: LIBERTY INSURANCE UNDERWRITERS 19917 <br />INSURED 1273 <br />INSURER B: Travelers Property Casualty Company of America 25674 <br />Century Structural Engineering Cc Inc <br />24719 Narbonne Avenue <br />INSURER C: <br />NSURER D: <br />Lomita CA 90717 <br />NSURER E : <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 1272056592 REVISION NUMBER: <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 />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ILTIRR <br />TYPE OF INSURANCE <br />ADDL <br />BUBB <br />POLICYNUMBER <br />MSU EFF <br />POLICY UP <br />LIMITS <br />B <br />X COMMERCIAL GENERAL LIABILITY <br />6802H676069 <br />9/20/2018 <br />9/20/2019 <br />EACH OCCURRENCE $1,000,000 <br />CLAIMS -MADE a OCCUR <br />DAMAGE TREN D <br />PREMISES Me occurrence) $1,000,000 <br />MED UP(Any oraperson) $5,000 <br />PERSONAL &ADV INJURY $1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE $2,000,000 <br />POLICY [fl jEo- FILOC <br />PRODUCTS-COMP/OP AGO $2,000,000 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />6002H676069 <br />9/20/2018 <br />9/20/2019 <br />COMBINED SINGLE LIMIT $1,000,000 <br />Ea accident <br />BODILY INJURY (Per pemon) $ <br />ANY AUTO <br />OWNEDSCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) $ <br />PROPERTY DAMAGE $ <br />Per accident <br />X <br />HIRED X NON-0WNED <br />AUTOS ONLY AUTOS ONLY <br />UMBRELLA LAID <br />OCCUR <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />EXCESS LIAR <br />CLAIMS -MADE <br />DEO I I RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY - YIN <br />PER OTH- <br />STATUTE ER <br />MWROPRIETOWPARTNEMEXECUTIVE <br />E.L. EACH ACCIDENT $ <br />OFFICERIMEMBEREXCLUDED7 ❑ <br />NIA <br />E.L. DISEASE -EA EMPLOYEE $ <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT $ <br />A <br />Professional Usb;Claims Made <br />AEX2004830118 <br />7/24/2018 <br />7/24/2019 <br />Per Claim 1,000,000 <br />Aggregate 1,000,000 <br />DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Addidanal Remark. Schedule, may be atlaehed if mora .peat is required) <br />The Certificate holder is an additional insured per the attached. <br />`\ , <br />I>Yh/1 <br />City of Santa Ana Planning And Building Agency <br />PO Box 1988 (M-19) <br />Santa Ana CA 92702-1988 <br />L"_1UP ggw_'\r DJc <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 />AUTHORIZED <br />w <br />TJHORIZED REPRESENTATIVE <br />4LAt. Jpo^-�lb <br />©1988-2015 ACORD CORPORATION. All <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />