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OF LIABILITY INSURANCE °57"iCERTIFICATE 0410/201 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED, the pollCy(les) must be endorsod. 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 holder in lieu of such endorsement(s). PRGUUCER Eddie Quillares Jr. State Farm Agency 415 N. DCO1dW8y Santa Ana, CA 92701 NAMT: T Eddie QUII(ares PNaNE f arl c iot:7 4. 17a7 a ADDRIRss: eddle eddle Insurance.com INSURGR S AFFORDING COV<?RAaE NAIC if INSURER A: State Farm Fire and Casually Cornoanv 26143 INSURED Ruben Alvarez INSURER8: INSURERC: i]DA Stay Connected QC INSURER D : -- 1101 W Walnut St T Santa Ana, CA 92703 INSURER E : INSURER F o COVERAGES CERTIFICATE NUMBER:75-0450 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTVYITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE 18SUED OR MAY PERTAIN, THE INSURANCE AFFORDED 0Y THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, 11 rsR LTR TYPE OF INSURANCE R POLICY NUM@ER POLICY EFF POLICY ExP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIANUTY CLAIMS -MADE ® CCCUR 92-EVW-381.6 03)2312017 03/23/2018 EACHOCCURRENCE S 1,000,000 PREMISES(Ea occ ace $ 300,000 MED EXP (Any one person) S 5,000 PERSONAL SADVINJURY S 1,000,000 GENERAL AGGREGATE S 2,00D.000 GEN'LAGGREGATELIMIT APPLIES PER: X1 FDLICY PROT LOG PRODUCTS-COMPlDPAGG S 2,000,000 S A€iTQMt]BILE tIAf3ILITY ANY AUTO ALL OWNED SCH15DULE0 AUTOS NON -OWNED HIRED AUTOS AUTOS ❑ ❑ �� �� Z �i � �+� �/ �� ,!� %, 1 C�OM6INED SIN LE LIM[T e accitlenl _ S BODILY INJURY (Per parsonl.....,5 SODILYINJURY (Pei acctdenl) $ PRCPERTY DAMAG Per accidenf $ S UMBRELLA LIAf3 EXCESS L(AB OCCUR CLAIMS -MADE µ - EACH OCCURRENCE $ AGGREGATES S DED RETENTIONS S WORKERS COMPENSATION AND EMPLOYER$' LIABILITY Y I N ANY PROPRIErORWARTNERIEXECUTiVG 017RCOMEMSER EXCLUDED? (Mandatory in NH) 11 yes, describe under N } A I� IL. .II �( WC 5TA € TORY $ OTH- E.L.EACH ACCIDENT 5 E1, 01SWE - FA EMPLGYEE .,...».".°".".,..,...." S E.L. DISEASE -POLICY LIMIT S n L�J DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (Attach ACORO tef, Additional Remarks Schedule, if more sp ee is required) City of Santa Ana 20 Civic Center Plaza P�0. Box 1988 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10 AC"C5 Cv RATION. All rights reserved. ACORL) Z5 (ZU10/05) I ne AUUKu name ano logo are reg€sTerea mar€cs oT v UUMU IUU 1-+0Q Ij/041U.r Uj-U i•/_U 1c