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AC6Rbr CERTIFICATE OF LIABILITY INSURANCE 1oATE(MAvoonrvp F 6/12/2017 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 be 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 holder In lieu of such endorsement(s). PRODUCER All -Cal Insurance Agency 505 Vernon Street Roseville CA 95678 221E0 DiAnna Martin PROM (: (916}784-9070 ac No:(916)784-0158 EMAIL ADDRESS: dianna@all-calinsurance. coon INSURERS AFFORDING COVERAGE NAIC0 INSURER A.Nonprofits I Insurance Alliance of 011845 INSURED The Los Angeles Dream Shapers P.O. BOX 3831 Orange CA 92865 INSURERB:State Compensation Insurance Fund 35076 INSURERC: INSURER D: INSURER E: 1 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1742506234 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. 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 TYPEOFINSURANCE ADDL SUSR POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY E%P MMIDD1YYYY Mine X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE OCCUR PREMISES Me oecurence $ 50Dr OOO x MEO EXP(Any one person S 20,000 LIQUOR LIABILITY X 2017-0H609NP0 6/13/2017 6/13/2018 $1,000,00011,000,000 PERSONAL& ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X JRO- LOC POLICY PRO PRODUCTS -COMPIOPAGG $ 2,000,000 S OTHER' AUTOMOBILE LIABILITY COMBINEOSINGLE LIMIT Ee acci. I S 1,000,000 BODILY INJURY (Par person) $ A ANYAUTO ALL OWNED SCHEDULED AUTX HIRED AUTOS X AUTOS 2017-08609NPO COt4P DED $500 6/13/2017 6/13/2018 BODILY INJURY (Per accident) $ Peerr�tle DAMAGE $ $ COLL DED $500 UMBRELLADAS OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLADAS-MAOE DED RETENTIONS S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE (Mandatory In NH) SER �UOE07 NIA 9015327-17 6/6/2017 6/6/2018 X STATUTE FOR"'- E.E. EACH ACCIDENT $ 1,000,000 E.L DISEASE - EA EMPLOYEE $ 11000,000 11 yes, desuihe urtler DESCRIPTION OF OPERATIONS hat. E.L DISEASE -POLICY LIMIT S 11000,000 DESCRIPTION OF OPERATIONS( LOCATIONS/VEHICLES (ACORD 101, Additional Remark$Schedule, may be attached it more space is required) THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS AND REPRESENTATIVES ARE NAME DITIONAL D IN REGARDS TO GENERAL LIABILITY. COVERAGE IS PRIMARY AND NON—CONTRIBUTORY. FORM CG 20 10 APPLIES NO, �Pd SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 CIVIC CENTER PLAZA ACCORDANCE WITH THE POLICY PROVISIONS. SANTA ANA, CA 92701 AUTHORIZED REPRESENTATIVE An& l' - ©1988-20 4 ACOJM COR RATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401)