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APOSASS-76 <br />CERTIFICATE OF LIABILITY INSURANCE DATE nA1A Y <br />nn rncMrnAAne a <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($), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADOITIONAL INSURED, the policy(les) must havo ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder In lieu of such endorsement(s), <br />PRODUCER License ff Ig2HPCT Carol Bush. <br />Services (ACG) I PHONE LAID <br />LAIC. E Evtl17$ . Nm49091 807-1245 <br />: <br />Mutual Insurance <br />Apostolic Assembly of the Faith in Christ Jesus dba Igiesla <br />Apostollca Sian <br />12942 Old Foothill Blvd <br />Santa Ana, CA 92705 <br />COVERAGES CERTIFICATE NUMBER: <br />REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOWHAVE,BEEN ISSUEDTOTHE INSURED NAMEDABOVE FOR THE POLICYPERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTOWHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br />TERMS, <br />EXCLUSIONS AND D CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAYHAVE BEEN REDUCED BY CLAIMS. <br />W <br />INSR <br />LTR TYPEOFINSURANCE <br />-PAID <br />ODL SU@R POLICY EFF POLICY EXP <br />i SD NNO POLICY NUMBER MMmDIYYgvl, FOOKIDIYYYY <br />LIMITS <br />A X coMMERCIAL OENERAL LIABILITY <br />EACH OCCURRENCE $-,,_ <br />1,000,000 <br />CUAIMSMADE X GccuR <br />04M5A0468911 091818017 09/8112018 <br />DAMAGE TO RENTED <br />1,000,060 <br />X X <br />PROMISES IRA csutrs $ <br />- <br />_ <br />10,000 <br />MEO EXP Any ane Pereon ._........... <br />1,000,006 <br />PERSONAL&ADV INJURY $__.. <br />GEN'L AGGREGATE L IMIT APPLIES PE R'. <br />GENERAL AGGREGATE <br />51060,000 <br />X POLICY El [__] LOC <br />JPFRCT <br />PRODUCTS-COMP/OP AGG <br />10001000 <br />OTHFR' <br />AUTOMOBILE LIABILITY <br />.„. <br />COMBINED SINGLE LIMIT <br />Ea accident)$ <br />ANYAPO <br />BODILY IN,AIRV (Per arson <br />OWNED SCHEDULED <br />AJ T�O�S ONLY AUTOS <br />BODILY IN3JRV Per eccltlen[ $ <br />I D <br />11AU IDS ONLY AUTOSOV <br />PPe�aoadeYrR�AMAGE <br />UMBRELLA. UAB OCCUR <br />EACH OCCURRENCE <br />EXCESSLIAB CLAMS-WDE <br />- <br />AGGREGATE <br />DED RETENTION$ <br />& <br />WORKERS COMPENSATION <br />PER OTFI- <br />ANDEMPLOYERS'UABIUTY <br />STATUTE ER <br />YIN <br />ANY PROPPIIETOORIPARTNER/EXECUTIVE <br />_ <br />E L. EACH ACC ]DENT <br />Mani dat0)ry ❑ <br />NIA <br />In NHL)Q"UDm? <br />EL DISEASE -EA EMPLOYEE $ <br />If vas. aeeaibo under <br />. <br />DESCRIPFIONOt OPERATIONSbelow <br />_ _,__ _. ____ <br />EL DISEASE -POLICY LI MIT...$ -... <br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101 Addltlonal Remarks Schedule, maybe attached if more space Is required) <br />RE: Use of parking lot at 308 N. Main Street, Santa Ana, CA. Certificate holder is named as additional insured. An insured may waive the right to recover, in <br />writing, before an occurrence takes place. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana, its officers, officials THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />employees and agents <br />ACCORDANCE WITH THE POLICY PROVISIONS, <br />20 Civic Center Plaza (M-25) <br />PO Box 1988 AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92702 <br />ACORD 26 (2016/03) 0 19$8-2015 ACORD CORPORATION. All rights reserved. <br />TheACORD name and logo are registered marks of ACORD <br />