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ACil CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDD/YYYY) <br />07/12/2017 <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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Rick Powell Insurance Agency, Llc <br />3500 West Olive Ave, Suite 300 <br />Burbank, CA 91605 <br />Phone (818) 861-7440 Fax (760) 804-9710 <br />CONTACT <br />NAME: Rick PDWBII <br />H9NN E (818) 861-7440 aC No : (760) 804-9710 <br />'MDREESAIL rick@insurance4ca.com <br />INSURERS AFFORDING COVERAGE NAIC H <br />INSURER A: HISCOX INSURANCE COMPANY INC. 10200 <br />INSURED <br />Kosmont & Associates, Inc. dba Kcsmont Companies <br />1601 N Sepulveda Blvd #382 <br />Manhattan Beach CA 90266 <br />INSURER B: <br />INSURER C : <br />INSURER D: <br />NSURE IS <br />NSURER F: <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ILTR <br />TYPE OF INSURANCE <br />IRL <br />UBD <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXP <br />LIMITS <br />❑ COMMERCIAL GENERAL LIABILITY <br />❑ CLAIMS -MAGE ❑ OCCUR <br />❑ <br />EACH OCCURRENCE $ <br />PAMAGE TO RENTED <br />REM SES Es occurrence) $ <br />MED EXP (Any ane person) $ <br />❑ <br />PERSONAL &ADV INJURY $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />❑ POLICY ❑ UEOT ❑ LOC <br />❑ OTHER <br />GENERAL AGGREGATE $ <br />PRODUCTS - COMP/OP AGO $ <br />$ <br />AUTOMOBILE LIABILITY <br />❑ ANY AUTO <br />ALL OW ❑ AUTOS NED ❑ SCHEDULED AUTOS <br />HIREDAUTOS ❑ -OWNED <br />❑ AUTS <br />❑ ❑ <br />COMBINED cident SINGLE LIMIT <br />Ea ac <br />BODILY INJURY (Per person) $ <br />BODILY INU URY(Per accident) $ <br />PPP0'CRd1nTAMAGE $ <br />$ <br />❑ UMBRELLA LIAB ❑OCCUR <br />❑ EXCESS LIAB ❑ CLAIMS -MADE <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />❑ DED ❑ RETENTION$ <br />_ <br />$ <br />WORKERS COMPENSATION <br />ANDEMPLOYERS' LIABILITY Y/N <br />ANY PROPRIETONPARTNEWEXECUI <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory In NH) <br />If yes, under <br />ONNun OPERATIONS beow l <br />DESCRIPTION <br />N /A <br />PER [-] <br />STATUTE ETRH- <br />E.L. EACH ACCIDENT $ <br />E.L. DISEASE - EA EMPLOYE $ <br />E.L. DISEASE - POLICY LIMIT $ <br />A <br />Errors & Omissions Coverage <br />Y <br />MPL1425837.17 <br />03/15/2017 <br />03/15/2018 <br />$2,000,000/$2,000,000 Per Claim/Aggregate <br />DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />Attn: Marc Morley <br />20 Civic Center Plaza (M-25) <br />Santa Ana, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />©1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014/01) OF The ACORD name and logo are registered marks of ACORD <br />