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DATE (MMIOD/YY <br />CERTIFICATE OF LIABILITY INSURANCE <br />6/19/201 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER..' <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLIC <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHOR12 <br />NTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />NT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject <br />and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to <br />e holder in I!#-- <br />ieu of such endorsement(s). <br />FTAN <br />PRODUCER <br />re Company <br />St., Suite D <br />5400 <br />Rancho' <br />Rancho Cucamonga CA 91729 <br />.__,,:PrEEerrEd <br />INSURED <br />Capital Enterprises, Inc.:P. 0. Box 893580- <br />CONTACT Selena Ramos <br />N ME: <br />_ <br />PHONE .tp (909)476-0600 FAX (909 7 6-0601 <br />AC Na:ademark <br />__ <br />E.MAa SRamos <br />AooREss: 6empire-co.com <br />__ INSURERISI AFFORDING COVERAGE <br />-- <br />I NgIC <br />I - <br />Employ, Ins. CO, _ <br />9 �:ADaerican <br />MED EXP IAnY ane person) $ <br />:—:TemeculaCA <br />I <br />PERSONAL & AOV INJURV <br />92589 <br />I <br />: <br />L{UVEKAui;Di ❑CATICir`ATC MIIRAC00.1 III <br />----- - rtcv WIVItl IVUiVIOCK: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 1 <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TER <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />LN9RI A OL us l <br />LTR r .TYPE OF INSURANCE INDIM POLICY NUMBER MMI01 pIYEYYY ! PMIOD EXP i— y— LIMITS <br />- COMMERCIAL GENERAL LIABILITY <br />J CLAIMS -MADE OCCUR <br />EACH OCCURRENCE $ <br />A <br />PRE IS Es 0CCU r Ce $ <br />MED EXP IAnY ane person) $ <br />��—'—"— <br />I <br />PERSONAL & AOV INJURV <br />j -_I ---- <br />IGEN'L AGGREGATE LIMIT APPLIES PER: <br />I <br />GENERAL AGGREGATE $ <br />POLICY 1:1 ECT LCC <br />-- <br />OTHER: <br />l AUTOMOBILE LIABILMI <br />f <br />ANY AUTO <br />IALL OWNED SCHEDULED <br />J AUTOS .—,y AUTOS <br />I NON -OPINED <br />HIRED ATCS _J AUTOS <br />- <br />j <br />PRODUCTS - COMP/OP AGG $_ <br />_ <br />— �— <br />COMBINE SINGLE LIMIT $ <br />(Ea ecdtlenll <br />BODILY INJURY (Per person) $ <br />.. .,..._._......,_.,.._.......... <br />BODILY INJURY (Per accident) $ <br />PROPERTY DAM GE <br />et amid nt $ <br />i OCCUR <br />1 EXCESS LIAa CLAINISMADEI' <br />(=PROPRIETORIPARTNERiEXEGUTIVE <br />N/Aj <br />i <br />WLCN140438-8 6 /1/2017 161 <br />I I <br />(AGGREGATE <br />L' <br />/ /2018,ibe <br />EACH OCCURRENCE <br />! DED RETENTIONS <br />COMPENSATION <br />OYERS• LIABILITY <br />11 N � <br />EMBERIEXCLUDED? CUTIVE f— <br />EMBEPEXCLVOE09 <br />In NHI '� <br />Under <br />ION OF OPERATIONS below <br />_S <br />:S STATUTE 0'fH <br />JR_.__.__.__.—_ <br />E.L. EACH ACCfOENT a 1,000 <br />E.L. DISEASE EA EMPLOYE9_ y,000 <br />E.L. DISEASE - POLICY LIMIT iS 1,000 <br />I <br />DESCRIPTION OF OPERATION37 LOCATIONS VEHICLES (ACORD 101, AdtllLonal Remarks Schetlule, may be attecbed if more apace is required) / <br />7 <br />APJpROED <br />rJ`u yp % a <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEF( <br />THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED <br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />PO Box 1983 M-17 <br />j AUTHORIZED REPRESENTATIVE Ana, CA 92702 <br />Icr_Ca Horr.aday/ERICA r�/-/.•GQ.---4�FC .r:ra-�=+rat <br />t <br />©1988-2014 ACORD CORPORATION. All rights reser <br />ACORD 25 (2014101) The ACORD name and logo are registered marcs of ACORD <br />IN5028 nm4ml <br />