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<br />CERTIFICATE OF LIABILITY INSURANCE 6/21/2016
<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(los) must be andorsed. If SUBROGATION IS WAIVE=D, subject to
<br />the terms and conditions of the policy, certatn Policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />PRQDVCPR
<br />ISU Insluranoe Services - Continal Agency, LLC
<br />250 exeo"tive hark Blvd
<br />Suits 4800
<br />San Francisco CA 94134
<br />INSURED f,-oVU-081
<br />California Barricade Rentals Inc l
<br />1550 9 Saint Gertrude Place
<br />�XAFI""' Fernando Rivas
<br />PH- ---- _ .
<br />`A tt4,_Sx)1E.(415)657-2000 — {AIC, Nall .1415)657 2002
<br />AOC.ADDRESS: f'er>;cando@isuca.Car{S
<br />.FIE$5:..............................___.._...._ _.
<br />INSURERIS A) FFORpING_COVERAOE NAIC 8
<br />ENSURER.Aim urance. Cgmpany
<br />tNSURFR_e NatiOnW:tde...btut:ua]._..Ins _.CC
<br />INSURERCNational Union Fire Ins Co of
<br />INSURER0 State Compmnka,t:ion_ Yna _Fund
<br />INSURER E;
<br />Santa Ana CA 92705 1 INSURt2 F:
<br />COVERAGES CERTIFICATF NUMBFR-16-17 GL. WC, Auto, X5 RFVISION NL]MFISR,
<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 CONTRAC-r OR OTHER
<br />DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
<br />HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSli _ -_ AODL'SUER - - - ._ ... Bdd'CCrCY E __ 4LrCy EXP..,.
<br />TYPE OF OF INSURANCH POLICY NUMBER Iw C4 Y ! Y
<br />...... -
<br />LIMITS
<br />X COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE $ 1,000,000
<br />..--- ----.
<br />A CLAIMS -MAGE X OCCUR
<br />--
<br />_,.,.._.-_.__.._.. _...
<br />OAMAGETO RENTED ....
<br />PREM)SES,(Egq;ourrepos). .$ 100,000
<br />X SCSO035435 7/1/2016 7/1/2017
<br />MUD EXP(Any on(iperson) $ axaludad
<br />PERSCNAL & ADV INJURY $ 1,000,1300
<br />GEML A00REGATE LIMIT APPLIES PER:
<br />GENrRAU AGGREGATE: $ 2,000,000
<br />X POLICY _ JE{CT LOC
<br />--- _.._..............__-
<br />1 ROOUC.IIIS ; COMPIOP AGO $ 2,000,000
<br />OTHER:
<br />Employee Booft $ 1, 000 , oO D
<br />AUTOMOBILE LIABILITY
<br />IN SINGLE LIMIT 100. 0.0..., OD 0
<br />_ X_ _ ANY AUTO W f
<br />B
<br />BO OILY INJURY (Par person) 5
<br />__...
<br />ALL OWNED SCHEDULED
<br />ALTOS AUTOS 7( ACP 307745230 7/1/201,fi 7/1/2017
<br />BQDEiYINJURY [Per ascrdeno $
<br />NON -OWNED
<br />._X HIRED AUTOS xAUTOS
<br />-P ibI;EIi7YOAMAGE ................ ..... ... —
<br />II'.arcccidanl) $ .............
<br />$
<br />UMBRELLA LIAR x OCCUR
<br />_EACH OCCURS ENCE$-_ - 5,000,000-
<br />C X EXCESS LIAR CLAIMS -MADE
<br />AGOREGATE _-- $ 5{000.,000
<br />EORmLTION V110 012013645 7/1/2016 7/1/2017
<br />g
<br />WORKERS COMPENSATION
<br />X ER OT -
<br />STATUTE......... ER
<br />ANO EMPLOYERS' LIABILITY Y 1 N
<br />.,.,...._
<br />PROPRIEfOPARTNERiEXECUTlVF ---._. NIA
<br />E:L_EACH ACCIDENT
<br />O�CERIMEM ERMEXCLUDED7
<br />D (Mandaiary In NH) 9063608-2016 7/1/2616 7/1/2017
<br />-
<br />E.L. DISEASE - EA EMPLOYEE. $ �0�600
<br />..__.._.-......_...
<br />Er�ras.daacnbaunder
<br />-
<br />OE5CRIPTEON OP OAEftATlO� S below
<br />E.L. DISEASE - POLICY LIMIT $ 1 oDD 000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 104, AdMilonal Remarka Schedule, may bo anxpllad It inure apace Is required)
<br />The Cit=y of Santa Ana, its offta tts, employees, agents, and representative
<br />are named a�saxfditional
<br />insured per form CG 20 33 04 13 and CO 20 37 04 13 on the GL policy,
<br />a !����
<br />e'o
<br />Additional insured applies per form AC 70 05 03 16 on the Auto policy,
<br />Those usual to the insured's operations,
<br />cio
<br />City of Santa Arta
<br />20 Civic Center Plaza - M-23
<br />Santa Ana, CA 92702
<br />SHOULD ANY OF THE ABOVE DESCRIEIE15 POLICIES BE CANCELLED BLFoRB
<br />THE EXPIRATION BATE THEREOF, NOTICE WILL 9E DELIVERED IN
<br />ACCORDANCE. WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />h Ferenc/F'R 4 "' +F
<br />(D1988.2014 ACORD CORPORATION. All riahts reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />INS025 on14011
<br />
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