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ACORO" <br />GOLDK-9-C <br />1 Eg 17 <br />�.� <br />CERTIFICATE <br />OF LIABILITY INSURANCE <br />DAM(MMICONYVV) <br />RTIFICATE IS ISSUED AS <br />A MA <br />ER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON T <br />CATE DOES NOT AFFIRM AFFIRMATIVELY <br />THIS CERTIFICATE OF <br />OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE <br />CERTIFICATE H30/2019 <br />O/LDER. THIS <br />AFFORDED BY THE POLICIES <br />ENTATIVE OR PRODUCER, <br />Fn <br />NSU <br />ND T <br />NCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSU <br />E CERTIFICATE HOLDER. <br />NG INSURER(S), AUTHORIZED <br />NT: If the certificate hol <br />OGATION IS WAIVED, sub <br />er is a <br />act to <br />ADDITIONAL INSURED, the pollCy(iss) must have ADDITIONAL INSU <br />the terms and conditions of the certain <br />ED provisions or be endorsed. <br />ificate does not confer ri ht <br />to the <br />policy, policies may require a <br />ertificate holder in lieu of such endorsements <br />endorsement. A statement on <br />icense#0757778ncr <br />. <br />Elizabeth Betts <br />erse,CA - HUB International Insurance <br />PO Box 5345 <br />Services <br />Inc. PHONE <br />ac, No, E#: (951) 779-8741 <br />1)7 9-874�,-__... <br />FAX <br />Riverside, CA 92517 <br />. IUC, No): <br />INSURED <br />Goldstone K-9 <br />35080 Goldstone Street <br />Yucaipa, CA 92399 <br />Ttl <br />rnueeAcC� <br />THIS IS TO CERTIFY THAT THE POLICIES <br />INDICATED. NOTWITHSTANDING ANY <br />CERTIFICATE MAY BE ISSUED OR MA <br />EXCLUSIONS AND CONDITIONS OF SUC <br />INSR rypE OF INSURANCE <br />A X COMMERCIAL GENERAL LIABILITY <br />OF <br />REQUI <br />PERT <br />POLICES. <br />ADD[ <br />an <br />REVISION <br />INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED <br />EMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER ED NAMEN <br />IN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN <br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />UBR POLL EFF POUCYEXP <br />j8m POLICY NUMBER <br />NUMBER: <br />ABOVE FOR THE POLICY PERIOD <br />WITH RESPECT TO WHICH THIS <br />ISSUBJE RESPECTTOWHICH HI <br />LIMITS <br />R, <br />ENCE <br />$ 11000000 <br />CLAIMS -MADE OCCUR <br />X <br />BKS56635216 9NEACHOCCU <br />/2019 9/1/2020 DAMAGETO <br />ENTED <br />500,000 <br />me on <br />NED EXP An <br />PERSONAL <br />GENERAL <br />PRODUCTS- <br />HNOA LIA <br />COMBINED SI <br />$ 15,000 <br />GEN'POLICY :1 LIMIT APPLIES PER <br />POLICY ❑ JEL� ❑X LOC <br />OTHER: <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />ADV INJURY <br />1.000,000 <br />REGATE <br />2,000,000 <br />OMP PAGG <br />2,000,000 <br />GLE LIMIT <br />1,000,000 <br />$ <br />Y PerPerson) <br />$ <br />OWNED SCHEDULED <br />AIUTEOOS ONLY AUTO <br />.pSSyy� p <br />AUTOS ONLY q�TOS OfY <br />BODILY INJUl <br />BODILY IN JU <br />PROPERTY <br />W a ent <br />V Peramitlen[ <br />$ <br />WAGE <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />$ <br />EXCES$LIAB <br />CLAIMS-MADI <br />EACH CU <br />ENCE <br />$ <br />DED RETENTION$ <br />AGGREGATE <br />WORKERS OY 1PRIABILIITY <br />AANNYPROPRIETOR/PARTNERIEXECUTIVE YIN <br />(Ma: Uat�Jn JWR (iDEOv <br />N / A <br />PER <br />OTH- <br />E.L. EACH AC <br />mENT <br />EA- DISEASE <br />EA EMPLOYE <br />"yea, tlesenbe untler <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE <br />POLICY LIMIT <br />The City of Santa AnalisNAdLOCATIONS <br />itional Insured <br />CG88100413. <br />with rce <br />aarrdt to Generall Liabillity`when required by written contract per the attache, <br />endorsement form <br />CERTIFICATE HOLDER <br />A r 1:0f I _ - — _ <br />City of Santa Ana <br />60 Civic Center Plaza <br />Santa Ana, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED <br />2019 THE EXPIRATION DATE THEREOF, <br />ACCORDANCE WITH THE POLICY PROVISI <br />AUTHORIZED <br />REPRESENTATIVE <br />h'L 1 Q�/'(In'jy411-AGFf=AG/iiL <br />ACORD 25 (2016/03) ©1988-2015 ACORD <br />The ACORD name and logo are registered marks of ACORD <br />S BE CANCELLED BEFORE <br />WILL BE DELIVERED IN <br />All rights reserved. <br />