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ACOOR" CERTIFICATE OF LIABILITY INSURANCE <br />ATE <br />D9/11/201Y7 ) <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 Ileu of such endorsement(s). <br />PRODUCER <br />Aegis Risk Management Insurance Services, Inc, <br />CA License 0735926 <br />3424 Carson Street Suite 300 <br />Torrance CA 90503 <br />CONTACT Keiko MOchina a <br />NAME: g <br />HONNo Ext: (310)793-1309 LAX. <br />X No:(310)793-1314 <br />-MAIL keiko.mochinag a@ae isrm.com <br />ADDRESS: g <br />INSURERIS) AFFORDING COVERAGE <br />NAIC# <br />INSURERAMitsui SUUhitOmO Ins CO of Amer <br />20362 <br />INSURED <br />Hoyu America Co., DBA: Samy Company <br />6265 Phyllis Dr. <br />Cypress CA 90630 <br />INSURERBMitsUi Sumitomo Ins USA Inc. (Aioi) <br />INSURERC: <br />INSURER D: <br />EACH OCCURRENCE $ 1,000,000 <br />INSURER E: <br />CLAIMS -MADE 5x]OCCUR <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER:EVENT: GL (NO PL) AUTO WC 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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADL <br />IND <br />B <br />WVD' <br />! <br />POLICYNUMBER <br />POLICY EFF <br />MMIDDIYYYV <br />POLICY EXP <br />MMIDDNM - LIMITS <br />Kiku Yenny/RENS r <br />X <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE $ 1,000,000 <br />A <br />CLAIMS -MADE 5x]OCCUR <br />D MA ET RENTED 100,000 <br />PREMISES Ea occurrence $ <br />X <br />PKG3126680 <br />9/1/2017 <br />9/1/201BMED EXP (Any one person) $ 5,000 <br />PERSONAL &ADV INJURY $ 1,000,000 <br />AGGREGATE LIMIT APPLIES PER: <br />GEN'L <br />GENERAL AGGREGATE $ 2,000,000 <br />X <br />POLICY [:]PRO- JECT El LOC <br />li <br />PRODUCTS-COMP/OPAGG $ <br />OTHER: <br />$ <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT $ 1,000,000 <br />Ea accident <br />A <br />X <br />: ANYAUTO <br />BODILY INJURY (Per person) $ <br />AUTOS OWNED SCHEDULED <br />IAUTOGr <br />AU <br />BVR8406337 <br />9/1/2017 <br />9/1/2018 BODILY INJURY (Per accident) $ <br />X <br />X NON-OWNED <br />PROPERTY DAMAGE <br />$ <br />HIRED AUTOS AUTOS <br />Per acaden[f.__ <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE $ <br />EXCESS LIAB <br />-MADE <br />AGGREGATE $ <br />_CLAIMS <br />DED RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />I PER I I OTH- <br />ANDEMPLOYERS'LIABILITY Y/N <br />STATUTE 1 .,-_ER <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />N/A <br />E.L EACHACCIDENT $ 1 0001000 <br />B <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory, in NH) - <br />WCP9112657 <br />9/1/2017 <br />-------- ---- <br />9/1/2018 E,L, DISEASE - EA EMPLOYE $ �1 09 00 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT 1 I 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be aftached if more spay qulred) <br />The City of Santa Ana, its officers, employees, agents, and represe0 ekives are A t_3onal Insured for <br />Commercial General Liability when required by written contract per endorsement 64 15 With respects <br />to the named insured's participation at The City of Santa Ana, 20 Civic Can z nta Ana CA 92701 <br />- Fiestas Patrias for the period 9/16/2017 to 9/17/2017. This certificat sr@Q any certificate <br />previously issued. �\ <br />0.J' <br />9� <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 25 (2014101) <br />INS025 omann <br />©1988-2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />Kiku Yenny/RENS r <br />ACORD 25 25 (2014101) <br />INS025 omann <br />©1988-2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />