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acaRn CERTIFICATE OF LIABILITY INSURANCE �' DA04/05/2018 05/18 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: If 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 certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Gary Bettis Bettis Insurance Services, Inc. 1725 S. Gaffey Street N-2018-132 aHCNro e.I: (310) 521-4480 plc, No: °aoI sz1-om ADDRESS: Second FSOOY San Pedro CA 90731 INSURERS AFFORDING COVERAGE NAIC p INSURERA:State Compensation Ins Fund INSURED INSURERS Shakespeare by the Sea INSURER C: 777 S. Centre Street INSURER D: INSURER E : San Pedro CA 90731 INSURER F: Llpv CrwuCJ I.CK I IFRJA IC INUIVICCK: REVISION NIIMRFR, 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. ILTR TYPE OF IN SURANCC INSR Wen POLICY NUMBER MMIDPOLIDNYCY YY MMDDIPOLICYYYYY LIMITS GENERAL LIABILITY Not Applicable EACH OCCURRENCE It COMMERCIAL GENERAL LIABILITY OAP occuma $ MED EXP (Any one person) $ CLAIMS -MADE 7 OCCUR PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO $ POLICY PRO- LOC - $ AUTOMOBILE LIABILITY sot Applicable COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per awldenl ( 1 $ HIREOAUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR of Applicable EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE OED RETENTION $ $ WGRKEas COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERAXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ NIA 09171.8-2018 03/01/2018 03 07/2029 - X WCBTATu- T V E.L. EACH ACCIDENT $ 1,000,000 E.L DISEASE -EA EMPLOYEE $ 1,000,000 (Mandatory In NH) If yes, describe under E,L DISEASE -POLICY LIMIT $ 1 000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) This certificate is issued as a matter of proof of workers compensation coverage only. \ 6l SHOULD ANY OF THE ABOVE DESCRIBBp POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE OLICY PROVISIONS. 20 Civic Center Plaza AumoRlzEDji1A�EA7�IV'Santa Ana CA 92701 I I ACORD 25 (2010108) ©1988-2010 ACORD CORPORATION. All rights reserved. IVDuGI (201uuai.ul The ACORD name and logo are registered marks of ACORD