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CERTIFICATE OF LIABILITY INSURANCE <br />FDATE <br />0612012018 YYYY) <br />THIS CERTIFICATE IS ISSUED ASA MATTER OFINPORMATION ONLYAND CONFERS NO RIGHTS UPON THECERTIFICATE MOLDER. THIS CERTIFICATE DOES NOTAPFIRMATIVELYORNEGATIVELY <br />AMEND, EXTEND ORALTERTHE COVERAGEAFFORDED BYTHE POLICIES BELOW.THIS CERTIFICATE OFINSURANCE DOES NOTCONSTITUTEACONTRACTSETWEEN THE ISSUING INSURER(S), <br />AUTHORIZED REPRESENTATIVEOR PRODUCER,ANDTHECERTIFICATE HOLDER. <br />IMPORTANT: lithe certificate holderlsanADDITIONAL INSURED, the poilcy(les) must hweADDITIONAL INSURED provisions orbeendorsed. USUbROGATION IS WAIVED, subjecttatheterms and <br />conditionsofthapolicy, certain policies may require an endorsement. Astatement on this certificate does not confer rights tothecerthica e, holder In lieu of such endorsement(c). <br />PRODUCER _ <br />CONTACT <br />Chuck Hyneman <br />18371-A Lemon Drive <br />NAME: Chuck Hyneman <br />PHONE <br />(A/C, NO, EXre 714.777-9823 <br />(A/C, No): 714-777.9898 <br />E-MAIL <br />Yorba Linda, CA 92886 <br />ADDRESS: <br />INSURER(S)AFFORDINGCOVERAGE <br />NAIC# <br />INSURED <br />INSURERA: United States Liability Insurance Company <br />�- <br />Second Chance Orange County <br />2618 San Miguel Dr#284 <br />Newport Beach, CA 92660 <br />INSURER a: State, Fund Insurance <br />INSURERC: <br />INSURER D: <br />INSURER E: <br />INSURER <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFYTHATTHE. POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMEABOVE FORTHE POLICY PERIOD INDICATED. NOTWITHSTANDINGANY <br />REQUIREMENT, TERM ORCONDITION OFANYCONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCEAFFORDED BYTHE <br />POLICIES DESCRIBED HEREIN IS SUBJECTTOALLTHE TERMS, EXCLUSIONSAND CONDITIONS OFSUCH POLICIES, LIMITSSHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OFINSURANCB <br />ADDTL <br />INSD <br />SUER <br />WVD <br />POLICY NUMBER <br />POUCYEFF <br />(MM/DD/YVYY) <br />POLICYEXP <br />(MM/DD/YYYY) <br />LIMITS <br />COMMERCIALGENERALLIABINTY <br />EACHOCCURRENCE <br />$ 1,000,000 <br />v <br />CIAIMSMADE !� OCCUR <br />DAMAGETORENTED <br />PREMISES (Ea Occurrence) <br />$ 100,00 <br />MED EXP(Anyone Person) <br />$ 6,00 <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />A <br />Y <br />NPP1578341 <br />06/20/2018 <br />09/14/2018 <br />GEN'L AGGREGATE LIMIT APPLIES <br />GENERALAGGREGATE <br />.$ 2,000,00 <br />jPER: <br />POLICY ❑ j <br />PROJECT u LOC <br />PRODUCTS -COMP/OPAGG <br />$ Include <br />$ <br />OTHER: <br />__--_ <br />AUTOMOBILE LIABILITY <br />COMBINEDSINGLE LIMIT <br />(Eaaccldent) <br />$ 1,000,000' <br />BODILY INJURY (Per person) <br />$ <br />ANYAUTO <br />BODILY INJURY(Perauddent) <br />$ <br />A <br />ON YEDAUTOS SCHEDULED <br />AUTOS <br />NPP1578341 <br />06/20/2018 <br />09/14/2018 <br />PROPERTY DAMAGE <br />(Per accidenU <br />$ <br />X HIREDAUTOS X NON -OWNED <br />ONLY AUTOSONLY <br />IR <br />IAL'AB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />LIAR <br />F <br />CLAIMS -MADE <br />AGGREGATE <br />$ <br />RETENTION$ <br />$ <br />WORKERSCOMPENSATION <br />AND EMPLOYERS' LIABILITY <br />PER <br />STATUTE <br />OTHER <br />$ <br />E.L. EACH ACCIDENT <br />$ 1,00000 <br />B <br />ANY PROPRIETOR/PARTNER/ Y/N <br />EXECUTIVE OFFICER/MEMBER <br />EXCLUDED7(Mandatory in NH) <br />N/A <br />922.6837-18 <br />06/20/2018 <br />03/01/2019 <br />E.L. DISEASE EA EMPLOYEE 1,000,000 <br />E. L. DISEASE POLICY LIMIT <br />$ 1,000,000 <br />byes, describe under DESCRIPTION OF <br />OPERA'TIONSIndow <br />A <br />Professional E&O Liability <br />NPPI678341 <br />00/20/2018 <br />G9/14/2019 <br />$1,000,000-Each <br />Incidenil <br />$2,000,000- <br />699regatee <br />DESCRIPTION OFOPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if marespace is required) <br />Loc: 1921 Baypointe Drive, Newport Beach, CA 92660 <br />Additional Insured: The City of Santa Ana <br />CERTIFICATE HOLDER <br />20 Civic Center Plaza M-25 <br />Santa Ana, CA 92301 <br />DATE <br />POLICY PROVISIONS. <br />ACORD 25 (2016/03) ©1988-2015 AC6RI) CORPORATION. All Rights Reserved <br />31-1769 11-15 The ACORD name and logo are registered marks of ACORD <br />/- <br />M <br />