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CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMIDDNYYY) <br />1 6/28/2018 <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 endomement(s). <br />PRODUCER <br />CONTACT NAME: Paul Romero <br />ROMERO INSURANCE AGENCY <br />PHONE 805-582-4655 <br />A/C Na Eat), <br /># : <br />ADDRESS: romeroins@aol.com <br />1197 E. LOS ANGELES AVE. UNIT C199 <br />INSURER(S) AFFORDING COVERAGE <br />NAICU <br />INSURER A: COLONY INSURANCE COMPANY <br />SIMI VALLEY CA 93065 <br />INSURED <br />INSURER e: CALIFORNIA AUTOMOBILE INS. CO <br />MAJOR LEAGUE INFIELDS INC 6_ao <br />INSURERC: SOUTHERN INSURANCE CO. <br />508 E. CHAPMAN AVE A- 4-0-1--007-0j <br />INSURER D: <br />INSURER E : <br />INSURER F: <br />FULLERTON CA 92832-2015 <br />COVERAGES CERTIFICATE NUMBER: 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 />LTR <br />TYPE OF INSURANCE <br />INSD <br />IWO <br />POLICYNUMBER <br />(MM/DDNYYY) <br />(MM/DD/YYYY) <br />LIMITS <br />X <br />COMMERCIAL GENERAL LUIBILITY <br />EACH OCCURRENCE <br />$ 2,000,000 <br />CLAIMS -MADE OCCUR <br />PREMISES (Ed occurrence) <br />$ 100,000 <br />MED EXP (Any one person) <br />$ 5,000 <br />PERSONAL S ADV INJURY <br />$ 2,000,000 <br />A <br />Y <br />Y <br />IOIGLOO23266-04 <br />07/1/18 <br />07/01/19 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERALAGGREGATE <br />$ 3,000,000 <br />POLICY F-1JECCT LOG <br />PRODUCTS-COMPIOP AGG <br />$ INCLUDED <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />Ea accident)$ <br />1000000 <br />x <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />B <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />Y <br />BA040000025174 <br />12/22/2017 <br />12/22/2018 <br />BODILY INJURY IPer accident) <br />$ <br />HIRED NON -OWNED <br />NLY AUTOS ONAUTOS ONLY <br />(Peracciden0 <br />$ <br />8 <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I I RETENTIONS <br />$ <br />C <br />ORKERS COMPENSATION <br />ND EMPLOYERS' LIABILITY <br />FFlCER/MEM DRIPARTNERIE ECUTIVE Y� <br />ER Mandatory in NH) <br />NIA <br />Y <br />OWC1006960 <br />01/01/I8 <br />01/01/19 <br />X STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E L. DISEASE- EA EMPLOYEE <br />$ 1,000,000 <br />f yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />EL DISEASE -POLICY LIMIT <br />1,000,000 <br />F1 <br />I <br />r <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached'rf more space is required) <br />CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED AS RESPECTS TO THE OPERATIONS OF THE NAMED INSURE H RESPECT TO CLAIMS <br />ARISING OUT OF THE OPERATIONS PERFORMED BY OR ON BEHALF OF THF.. NAMED INSURED, SUCH INSURANCE AS [ RDED BY THIS LICY IS <br />PRIMARY AND NOT ADDITIONAL TO OR CONTRIBUTING WITH ANY OTHER INSURANCE CARRIED BY OR FOR FIT QA D ONAL <br />INSURED. 10 DAY NOTICE FOR NON PAYMENT OF PREMIUM. e�� f/ <br />CITY OF SANTA ANA ITS OFFICERS, EMPLOYEES, <br />AGENTS AND REPRESENTATIVES <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92701 <br />SHOULD ANY OF THE ABOVCDESCRIBE iDLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTIC WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />FIX" Rotwaoa <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />