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CERTIFICATE OF LIABILITY INSURANCE DATE UUNDDNYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: N the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the eertlficate holder in lieu of such endomement(s). PRODUCER NAME: Aacay e1111amz Mt. Diablo Insurance Brokers, Inc. PHONE (925)297_gp72 F 3557 Mt. Diablo Boulevard AD.Ess:kathy@mtdiabloinsurance.com Spite 21 INSURERS AFFORDING COVERAGE Lafavette CA 94549 IMURERAAssociated Industries Insu1 INSURED INsuRER9:StarStone National Insurance Co. ZOGNO U S National Corp. IMSURERCJ3eazley Syndicates 37540 DBA: Jimenez Painting INSURERD: PO Box 4929 INSURER E: Panorama City CA 91412 INSURER F: c unuovnAmR air. RFVI.glnhlNIIMRFR- V THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE R POLICY NUMBER m�� DDY E%P LIMITS X COIRM MIAL GENERAL LNBILIY EACH OCCURRENCE $ 1,000,000 A CLAaiSAUIDE OCCUR DWA-GET15 RENTED PREMISES I, acwrrance $ 100,000 MED D(P(Am/mapelson) $ 2,500 X MS103836503 4/25/2018 4/25/2019 PERSONAL a ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGO $ 2,000,000 X POLICY ❑ JET D LOC OTHER. S AUTOMOBILE LIABILITY COM IN INGLE UNIT Ea actltlent $ BODILY INJURY (Per person) $ ANY AUTO BODILY IWURY(Per aalden) f ALLOWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS AUTOS PROPERTY DAMAGE flwWwO S S X UMBRELLA UAS X OCCUR EACH OCCURRENCE S 5 000 000 AGGREGATE $ 5,000,000 B EXCESS LWB CLAIMS -SHOE 8B144X381ALI 4/25/2018 4/25/2019 DED I I RETENTION$ $ WORKERS COYPEHSATION AID EMPLOYERS LNBRRY YIN ANY PROPRIETORMARTNERIEXECUNVE I BRATUTE I I ER E.L EACH ACCIDENT f E.L. DISEASE - EA EMPLOYEE f OF CERNEMBER EXCLUDED? ❑ (M.dsbry in NMI NIA E.L. DISEASE- POLICY LIMIT $ Dyes, tlesnike uMer DESCRIPTION OF OPERATIONS W. DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, AMMmal Remarks Sakedule, may a aea ff more space is required) The City of Santa Ma, its officers, agents, employees, volunteers and represenatives are recognized as additional insured, but only as respects liability arising from named insured operations. Endorsements apply and are attached hereto. *30 days written notice of cancellation. 10 days notice for non-payment of p '. um. ./ X'.� � Q City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Salvo/KATHY - - -- -- 01988-2014 ACORD CORPORATION. All rights reserved. J ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 i201401)