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ACOP ®® CERTIFICATE OF LIABILITY INSURANCE ATE (MMIDDIYYYYj p1/31/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must he endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate molder in Iieu of such endorsement(s). PRODUCER NAMEA T Lizette Bargas PHONE (909) 987-7600 FAX (909)967-7656 Amorelli Rosemann & Associates Ins Svcs Inc 3333 E Concours St 'MAILDDRESS: lizetteb@arainsurance.com A INSURER(S) AFFORDING COVERAGE NAC 0 Building 9-200 INSURERA:State Comp. Insurance Fund 35076 Ontario CA 91764 INSURED INSURER 8 INSURER C: Mdg Associates, Inc. INSURER D: 10722 Arrow Route Ste 822 INSURER E : GENERAL AGGREGATE $ INSURER F: Rancho Cucamonga CA 91730 COVERAGES CERTIFICATE NUMBER-CL1662914586 REVISION NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADO BR POLICY NUMBER POLICY EFF MM DD POLICY EXP D LIMITS 20 CIVIC CEN'T'ER PLAZA SANTA ANA, GA 92701. COMMERCIAL GENERAL LIABILITY CLAIMS -MADE D OCCUR Lizette Bargas/LTZETT� EACH OCCURRENCE $ AAl OPRREMISVMIS TO RE TED ES Ea occurrersce $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRC ❑ LOC JECT OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per acdclenl UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PRCPRIETORIPARTNERIEXECUTIVE OPFICERIMEMBER EXCLUDED? (Mandatory In NH) I yes,descrlbe under DESCRIPTION OF OPERATIONS below N I A 1960750-16 7/1/2016 7/1/2017 S I STATUTE ORH E. L. EACH ACCIDENT 1 $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 11000,000 E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) PROOF OF INSURANCE FOR CERTIFICATE HOLDER. CERTIFICATE HOLDER CANCELLATION \.'; %J O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 rim 401 f SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: TERRT EGGERS, SENIOR MNGMT. ANALYST ACCORDANCE WITH THE POLICY PROVISIONS. COMMUNITY DEVELOPMENT AGENCY AUTHORIZED REPRESENTATIVE 20 CIVIC CEN'T'ER PLAZA SANTA ANA, GA 92701. _ Lizette Bargas/LTZETT� O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 rim 401 f