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CERTIFICATE OF LI)
<br />IN FS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ON
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEN!
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITI
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, tho
<br />terms and conditions of the policy, certain policies may require an al
<br />certificate holder in lieu of such endorsamont(s).
<br />PRODUCER Eddie QUillares Jr.
<br />State Farm Agency
<br />415 N. Broadway
<br />1 Santa Ana, CA 92701
<br />,NCIUKLU Melody Gonzalez
<br />2806 VV Harvard St
<br />Santa Ana, CA 927Q4
<br />DATE(MMIDDIYYY)
<br />0LBILITY INSURANCE
<br />AUdANE 0/4
<br />17
<br />_Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />P, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />TE A CONTRACT BETWEEN THE ISSUING, INSURER(S), AUTHORIZED
<br />yOlicy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the
<br />Idorsoment. A statement on this certificate does not confer rights to the
<br />AC
<br />N°ME: Eddie Quillares
<br />PHONE .714 61 % 50.
<br />FAX o : 14.677.7158
<br />A4 RESS.. addle eddie insurance,Dam
<br />fNffiURE 8 AFFORDING COVERA43E NAIC f�
<br />INSURER A: State Farm General Insurance Comp—any 2 151
<br />INSURER 13
<br />INSURER C:
<br />INSURER D :
<br />INSURER E:
<br />INSURER F;
<br />OVERAGES CERTIFICATE NUMBER: 75-0460
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSU
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHEF
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIE
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCER BY PAID CLAIM
<br />mr
<br />TR TYPE OF INSURANCE
<br />A GENERAL LIABILITY
<br />X] COMMERCIAL GENERAL LIABILITY
<br />I CLAIMS -MADE I OCCUR
<br />UMBRELLA L1ABI OCCUR
<br />EXCESS LIAB I�--�il r1 nir,ac
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS, LIABILITY
<br />ANY PROPRIETORIPARTNERIEXEGUTWE Y I N
<br />OFFICEIMEMBER EXCLUDED? ❑ NIA
<br />(Mnndatnry In NH)
<br />If yas, describe under
<br />92-CE•Q933-0 05/06/2017 10514612017
<br />DESCRIPTION OF OPERATIONS ! LOCATIONS IVEHIRLES (Attach ADORD 1I61, Addiilonai Retnark6 Schedule, if more space Is required)
<br />Cinco De Mayo Celebration in Downtown Santa Ana. CUNYA will be performing between 5pm-7pm an the Main S
<br />THE CITY OF SANTA ANA, IT'S OFFICERS, EMPLOYEES, AGENTS, AND REPRGSENTATRtF ARE NAMED A
<br />GENERAL LIABLITY PER ATTACHED EXHIBIT 8 ADINTINOAL INSURED FORM,
<br />CANCE
<br />ti"vl, Ivrd rvvlwo IS:
<br />RED NAMED ABOVE FOR THE POLICY PERIOD
<br />DOCUMENT WITH RESPECT TO WHICH THIS
<br />ED HEREIN 15 SUBJECT TO ALL THE TERMS,
<br />i.
<br />LIMITS
<br />EACH OCCURRENCE $ 1,000,000
<br />PRE:M155S Eac,=LIM nce S 300,000
<br />MEC) EXP (Any one parson) $ 5,000
<br />PERSONAL &ACV INJURY 5 1,000,000
<br />GEN ERAL AGGREGATE $ 2,000,000
<br />PRODUCTS-COMPIOP AGG $ 2,000,000
<br />—CO—MR NED
<br />Eaaccddenl ING LIMIT $
<br />BODILY INJURY (Per person) $
<br />BODILY INJURY (Per acddenf)
<br />PROPERTY
<br />acddonl DAMAGE $
<br />EACH OCCURRENCEgR
<br />AGGREGATE�ATU- E.L. EACH ACCIDENTEL_ DISF_ASE - EA EM
<br />E.L. DISEASE - POLICY LIMIT S
<br />S
<br />age
<br />7 ADDITIONAL INSURED IN REGARDS TO
<br />*LAITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRI13ED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 CIVIC CENTER PLAZA ACCORDANCE WITH THE POLICY PROVISIONS.
<br />SANTA ANA, CA 92701
<br />O 110 ACORD CORPORATION. All rights reserved.
<br />ACORD 26 (2010105) The ACORD name and logo are re ered m i s of ACORD 1001486 132849.7 03-01-2012
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PCYLICY PRO
<br />1 LOC
<br />AUTOMOBILE LIABILITY
<br />ANY AUTO
<br />AOWNED
<br />SCHEDULED
<br />AUTOS
<br />AUTOS
<br />HIREDAUT0$
<br />NON -OWNED
<br />AUTOS
<br />UMBRELLA L1ABI OCCUR
<br />EXCESS LIAB I�--�il r1 nir,ac
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS, LIABILITY
<br />ANY PROPRIETORIPARTNERIEXEGUTWE Y I N
<br />OFFICEIMEMBER EXCLUDED? ❑ NIA
<br />(Mnndatnry In NH)
<br />If yas, describe under
<br />92-CE•Q933-0 05/06/2017 10514612017
<br />DESCRIPTION OF OPERATIONS ! LOCATIONS IVEHIRLES (Attach ADORD 1I61, Addiilonai Retnark6 Schedule, if more space Is required)
<br />Cinco De Mayo Celebration in Downtown Santa Ana. CUNYA will be performing between 5pm-7pm an the Main S
<br />THE CITY OF SANTA ANA, IT'S OFFICERS, EMPLOYEES, AGENTS, AND REPRGSENTATRtF ARE NAMED A
<br />GENERAL LIABLITY PER ATTACHED EXHIBIT 8 ADINTINOAL INSURED FORM,
<br />CANCE
<br />ti"vl, Ivrd rvvlwo IS:
<br />RED NAMED ABOVE FOR THE POLICY PERIOD
<br />DOCUMENT WITH RESPECT TO WHICH THIS
<br />ED HEREIN 15 SUBJECT TO ALL THE TERMS,
<br />i.
<br />LIMITS
<br />EACH OCCURRENCE $ 1,000,000
<br />PRE:M155S Eac,=LIM nce S 300,000
<br />MEC) EXP (Any one parson) $ 5,000
<br />PERSONAL &ACV INJURY 5 1,000,000
<br />GEN ERAL AGGREGATE $ 2,000,000
<br />PRODUCTS-COMPIOP AGG $ 2,000,000
<br />—CO—MR NED
<br />Eaaccddenl ING LIMIT $
<br />BODILY INJURY (Per person) $
<br />BODILY INJURY (Per acddenf)
<br />PROPERTY
<br />acddonl DAMAGE $
<br />EACH OCCURRENCEgR
<br />AGGREGATE�ATU- E.L. EACH ACCIDENTEL_ DISF_ASE - EA EM
<br />E.L. DISEASE - POLICY LIMIT S
<br />S
<br />age
<br />7 ADDITIONAL INSURED IN REGARDS TO
<br />*LAITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRI13ED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 CIVIC CENTER PLAZA ACCORDANCE WITH THE POLICY PROVISIONS.
<br />SANTA ANA, CA 92701
<br />O 110 ACORD CORPORATION. All rights reserved.
<br />ACORD 26 (2010105) The ACORD name and logo are re ered m i s of ACORD 1001486 132849.7 03-01-2012
<br />
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