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ADLER-1 CHIP ID: BOBO
<br />Q� DATE WAVONYYYYi
<br />CERTIFICATE OF LIABILITY INSURANCE 08125f2017
<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 endorsemant(s),
<br />PRODUCER COMA
<br />NAME;_ Roberta_R Roses
<br />Loomis insurance Services PHONE
<br />92519 !,
<br />wsuaEo Adierhorstinternational, L1. LC
<br />3951 Vernon Avenue
<br />Riverside, CA 92509
<br />r.nVFRAI CFRTIFICATF. NTMBFR: REVISION NUMBER:
<br />THIS IS 10 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 10 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OCHER 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
<br />THE PERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR� ,,.... _._. .....,4DDLRuUeR)._.-...- POC(LV GEP...L. POLICY EXP /._ _.._-_.. _..
<br />.
<br />L TYPE OF INSURANCE MSR awn n, POLICY NUMBER IMWOOWYYYt . (M�/UWYV1'x�,y_ LIMIT'S
<br />.._
<br />GENERAL
<br />RAL LLIABILITY FI ( i EACH OCOURS
<br />1,000,000
<br />X'_.
<br />I- DAMAGE"TU RENTED
<br />A axaMERaAL OFiNER(J.LwaalTv X - EW592208$ t}8t0817` t2408t0$J241$IPREM�sEs l„An,l
<br />"""'••
<br />100,000
<br />,S,_
<br />CLAIMS-MACE Ya F OCCUR ' MED EXP {AnTone personl S
<br />5,000
<br />_
<br />PERSONAL SAW INJURY S
<br />1000,000
<br />w. ..........
<br />GENL AGGREG ATE LIMIT' APPLIES PER PRODUCTS COMPIOPAGG ! S
<br />_._
<br />EXCLUDED
<br />G.. C
<br />I PRO. l ... __.
<br />... �.6...,..l.w1Pria��....,...,.J.....,,,-�._
<br />,......_ T- ....-.,-,S
<br />A�OMOtllLE LIABILITY -COMBINED SINGLE LIMIT
<br />I
<br />BODILY INJURY IPer p r nl S
<br />i ANY AUTO
<br />! IAL40WNED —SCHEDULED BODILY INJURY (f>er ec ltlenp�,%
<br />Ip. jL,�
<br />AUTOS AUT05 -
<br />NON OWNED iIFROPERTY DAMAGE S
<br />HIREDAUTOS _ _..AUTOS LOPER ACCIDENT)
<br />MORLLA R 1^— EAc.H OCCURRENCE rb OCCU
<br />eXG S$IiABAR
<br />S ,CLAIMS-M,4DE� ' AGGReGAT E
<br />Y
<br />^mI_
<br />OE-Q tETENTKINS1 t w S
<br />WORKERS COMPENSATION WC STATU- OTH 3
<br />I AND EMPLOYERS' U SILITY Y r N TDRX3.mntTS_
<br />ANY PROPRM ORmARTNER,EXECUTIVE ( E L EACri ACCIDENT ; S
<br />OFflCERAMEMBER EXCLUDED, ❑ ;NIA -- - - ,
<br />(manJaio,y in NH) EL OISEASE EA EMPLOYEE S,
<br />If y24 tleso(ibeubtlel
<br />bC,?CRIPT,LO);t OFOPERATIONS below EL. DISEASE -POLICY LIMIT S
<br />I
<br />,
<br />DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES IAnapn 0.COR01e1, Additional Renla Ma SCOntlule, it more apace is required)
<br />The City of Santa Ana, its officials, officers, employees, agents,
<br />volunteers I representatives are named as Additional Insured. Coverage is
<br />Primary & Non --Contributory, 30 day Notice of Cancellation applies except. for
<br />10 day Notice for Non-payment of Premium.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />The City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />y ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701 AUTHORIZED REPRasENTATIVE .,__
<br />(),. Q10,4I
<br />U 198U-ZU1U AGUKU cORr URAI ION. All rlgnts reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />AY-'.svari2r�
<br />
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