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A� l CERTIFICATE OF LIABILITY INSURANCE <br />9ja/20171DDmrrl <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(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsements . <br />PRODUCER <br />Arthur J. Gallagher Risk Management Services, Inc. <br />4700 Homewood Court <br />Suite 260 <br />CONTACT <br />NAME: Lori E. Staples <br />PHHONN EA, 336-217-5767 FAIAC'Na). 336-275-1776 <br />E-MAIL .lori_staples@ajg.com <br />INSURERS AFFORDING COVERAGE <br />NAICH <br />Raleigh NC 27609 <br />INSURER A: Sentinel Insurance Com an Ltd <br />11000 <br />INSURED <br />INSURER B : <br />INSURER C : <br />Telerent Leasing Corp <br />4191 Fayetteville Rd <br />Raleigh, NC 27603 <br />INSURER D: <br />INSURER E : <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 1158748159 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 />rypE OF INSURANCEADDLSUBR <br />INSD <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM/DD/YYYY <br />POLICY EXP <br />MMIDDIYYYY <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />CLAIMS4ADE OCCUR <br />DAMAUL U RENTEO <br />PREMISES Ea occurrence <br />$ <br />MED EXP(Any one person) <br />$ <br />PERSONAL &ADV INJURY <br />$ <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ <br />GEHL <br />POLICY PRO- <br />JECT LOG <br />PRODUCTS_COMP/OP AGG <br />$ <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SI NGLE LI MT <br />Ea accident <br />$ <br />BODILY INJURY (Per person) <br />1 $ <br />ANYAUTO <br />OWNED ASCHEDULED <br />AUTOS ONLY UTOS <br />BODILY INJURY (Per accltlern)!$ <br />HIRED NON-ONMED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTYDAMA E <br />Per accidenlZ_ <br />.$ <br />is <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION$ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANVCER/MEETOR/PARTNDED? WTIVE <br />EXCLUDED? <br />CFFI(Mandatory <br />N/A <br />22WBAA3GT9 <br />6/30/2017 <br />6/30/2018 <br />PER OTH- <br />Y` STATUTE <br />_ER <br />L. EACH ACCIDENT <br />$1,000,000 <br />- <br />E.L. DISEASE -EA EMPLOYEE <br />$1,000,000 <br />NH) <br />InN ) <br />Use, describe <br />Dyes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached it more space is required) V <br />RE: Roosevelt/Walker Community Center, 501 S. Halladay St., Santa Ana, CA. �Psi\ <br />�� <br />C <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Clerk Of City Counsel <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza (M-30) <br />PO Box 1988 <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92702-1988 <br />@ 1988.2015 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD <br />