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a� cr CERTIFICATE OF LIABILITY INSURANCE <br />°1vzzi2017 <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($), 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 the <br />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 endorsement(s). <br />PRODUCER Eddie QUillares Jr. State Farm Agency <br />415 N. Broadway <br />Santa Ana, CA 92701 <br />NAME: C Eddie Qulllares Jr. <br />PHONE 7 4 7 FAX NP( 71 71 <br />EMAIL <br />ADD addle eddieginsurance.com <br />� <br />_ <br />INSURERS AFFORDING COVERAGE NAZCA <br />INSURER A: State Farm Fire and Casualty Company 25143 <br />INSURED Santa Ana Chamber of Commerce <br />1631 W. Sunflower Ave STE C35 <br />Santa Ana, CA 92704 <br />ATTN: Marty Perterson <br />INSURER 8: $IatB Fafm-GBnera nSUraOCe QDmpanv 25 <br />INSURER C: <br />INSURERDom_ _ <br />INSURER E,_ <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 7S -04F0 RFl/ISTInM IUIIMRGG• <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 />I <br />LTR <br />TYPE OF INSURANCE <br />ADDLISL <br />INSR <br />WVDUIRIPOLICY <br />NUMBER <br />MMDDIYYVVY <br />MMIDONYYY <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X1 COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE ❑OCCUR <br />Y <br />92 -CM -E499.2 G <br />0310112017 <br />0310112018 <br />EACHOC RET $ 3,000,000 <br />P0_REMISES (Ee occur encej_,$ 300,000 <br />MEDEXP�(An�neperson) $ 10,000 <br />PERSONAL B ADV INJURY $ 3,000,000 <br />GENERAL AGGREGATE It 61000,000 <br />GEN'L AGGREGATE LIMITAPPLIES PER: <br />POLICY PR LOC <br />PRODUCTS-COMPIOP AGO $ 61000,000 <br />B <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OSCHEDULED <br />AUUTOSS AUTOS <br />HIREDAUTOS x NON -OWNED <br />AUTOS <br />431 0540-C01.75 <br />0910112017 <br />03/01/2018 <br />CJE.OMBINED <br />NccidEryl SINGLE LIMIT $ <br />BODILY INJURY (Par person) $ 1,000 <br />BODILY INJURY Per accldan0 $ 1,000 <br />PROPERTY DAMAGE <br />Per egciden[ $ 1,000 <br />$ <br />UMBRELLA LIAa <br />EXCESS LIAO <br />OCCUR <br />R <br />CLAIMS -MAGE <br />�❑ <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />DEO I I RETENTION$ <br />$ <br />Q <br />WORKERS COMPENSATION <br />ANDEMPLOYERVLIABILITY YIN <br />ANY PROPRIETORIPARTNENEXECUTIVEE.L. <br />OFFICEIMEMBER EXCLUDE04 Y❑ <br />(Mandatory In NH) <br />II Vsa, daseriba under <br />PWQM,1IQN OF OPERATIONS uel <br />NIA <br />92 -EB -E908-0 <br />02/01/2017 <br />02/0112018 <br />x WC BTATU- OTH- <br />JQBY LIMITS ER <br />EACH ACCIDENT $ 11000,000 <br />E.LDISEASE-EAEMPLOYE $ 1,000,000 <br />E. L. DISEASE -POLICY LIMIT $ 11000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AHach ACORD 101, Additional Remarks Schodulo, it mare space is required) <br />CERTIFICATE HOLDER renlcFl 1 ATInM <br />City of Santa Ana <br />20 Civic Center Plaza <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />Q 1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 <br />