Laserfiche WebLink
A CERTIFICATE OF LI) <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ON <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENI <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, the <br />terms and conditions of the policy, certain policies may require an a <br />certificate holder In Ileu of such endorsement(s). <br />PRODUCER Eddie Quillares Jr. <br />State Farm Agency <br />415 N. Broadway <br />Santa Ana, CA 92701 <br />INSURED Gloria Arjona <br />4515 E Harvey Way <br />Long Beach, CA, 90808 <br />-__[AT 01MILITY INSURANCE a5/02/2017 <br />.Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS <br />I, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />ITE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED <br />)aliCy(ies) must be endorsed. It SUBROGATION IS WAIVED, subject to tale <br />Idorsament. A statement on this certificate does not confer rights to the <br />NAA T Eddie Oulllares <br />PHONE 71 17. 150. <br />-MAIL AC No .7'14 7. 8 <br />AODRE ; eddie eddi insurance,com <br />INSURERS AFFORDING COVERAGE MAIC v <br />INSURER A; State Farm General Insurance Compsay 25151 <br />INSURER 8: <br />INSURER C : <br />INSURER 0: <br />INSURER E <br />INSURER F: <br />r u-u-tuv <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSU <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM CR CONDITION OF ANY CONTRACT OR OTHEF <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIE <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIE=S. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM <br />SSR <br />-TR TYPEOFiN$URANCE UBR POLICY NUMIDERIAMfppY MLOCYEXP <br />A GENERAL LIABILITYMM <br />Y�Y 82 -CE -Q933-0 05!0612017 05/06/2017 <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE 7XI OCCUR <br />I _ <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />POLICY PRO- I I LOC <br />AUTOMOBILE LIABILITY <br />El <br />ANY AUTO <br />ALL OWNEDSCHFOULED <br />AU7oS AUTOS <br />HIRED AUTOS AUT NON-OWNED <br />EXCES <br />LIAR H OCCUR Q ❑ ?,1 <br />EXCESS L -U AB ry nixie Bunn <br />WORKERS COMPENSATION <br />AND EMPLOYERS, LIABILITY <br />YIN <br />ANY PROPRIETORIPARTNRRIEXErCUTIVE <br />OFFICEIMEMBER EXCLUDED? N f A EF <br />(Mandatory In NH) iJ <br />If yes, (lowbe under <br />DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (Attach ACORD 901, Additional Romarka Sehadula. if more space is mgtIII <br />Cinco do Mayo Celebration in Downtown Santa Ana, Gloria Arjona will be performing t)etween 6:30pm-8:30pm <br />City of Santa Ana its officers, agents, employees and volunteers are named as additional insured. Exhibit B is atta <br />SED NAMED ABOVE FOR THE POLICY PERIOD <br />DOCUMENT WITH RESPECT TO WHICH THIS <br />ED HEREIN IS SUBJECT TO ALL THE TERMS, <br />i, <br />LIMITS <br />EACH OCCURRENCE S 1,000,000 <br />N <br />PREMISES Eaeeturrence $ 300,000 <br />MED EXP (Any one on) $ 5,000 <br />Pi RSONALB,ADVINJURY $ 1,000,000 <br />GENERALAGGREGATE $ 2,000,000 <br />PRODUCTS-COMPIOPAGG $ 2,000000 <br />S <br />� <br />ENNEDE <br />SINOLLIMIT <br />eaf$ <br />BODILY INJURY (Perperson) ,$ <br />BODILY INJURY (Perw4dent) $ <br />PROPP-RT -DAMAGE $ <br />$ <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />S <br />V� STATT- <br />0TH- <br />E.L. EACH ACCIDENT $ <br />E.L. DISEASE - EA EMPLOYE $ <br />E.L. DISEASE -POLICY LIMIT 5 <br />;hed. <br />CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE <br />THE: EXPIRATION PATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 CIVIC CENTER PLAZA SANTA ANA, CA 92702 ACCORDANCE WITH THE POLICY PROVISIONS. <br />ATTENTION RISK MANAGEMENT <br />SONIA BATRES AVTHFREPTIVE <br />0 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010105) The ACORD name and logo are regiACORD 1001486 132849.7 03-01-2012 <br />