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ACe7Ra CERTIFICATE OF LIABILIT`! INSURANCE <br />DATE (MOM DDIYVYY) <br />III.iOB/22/2018 <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 CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT, If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have 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 sue h endorsement(s), <br />PRODUCER <br />Co ECT <br />NAME: Dori Jared-Ferrento <br />Assistance Insurance Agency <br />PHONE (714) 245-2777 FAx 714 2 <br />MAIL--"'-'-'"' AICa No): ( ) 45-2758 <br />123 E. 9th Street <br />goORESS: dialed@asslstanceins.com <br />Unit 314 <br />_ INSURERIS) AFFORDING COVERAGE <br />NAICN <br />Upland CA 91786 <br />e.............. <br />INSURER A: State Compensation Insurance Fund <br />INSURED <br />INSURER B : <br />Manuel Huanta, DBA: Stage Plus, Inc. <br />INSURER c: <br />2330 S. Susan St. <br />INSURERD: <br />INSURER E : <br />Santa Ana CA 92704 <br />- <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 18-19 WC REVISION NUMBER: <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 MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ILTR <br />TYPE OF INSURANCE <br />ADDI- <br />INSD <br />DR <br />V <br />POUCYNUMBEft <br />POLICY EFF <br />MMIDDIYYYY <br />POLICYEXP <br />MMIOOIYYYY <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CMSAtlE CC MOUR <br />EACH OCCURRENCE <br />sLAI <br />A <br />PREMISES Ea AX(TlTE ence <br />§ <br />MEd EXP(Any one Person) <br />§ <br />PERSONAL &ADV INJURY <br />§ <br />GEN'LAGGREGAE UMTAPPLIES PER: <br />POLICY D PRO TOO <br />GENERALAGGREOATE <br />5 <br />PRODUCTS-COMPIOPAGG <br />§ <br />S <br />OTHER' <br />AUTOMOBILE <br />LIABILITY <br />COMBINE -SINGLE LIMIT <br />Ea accident <br />S <br />ANYAUTO <br />BODILY INJURY(P., Oersan) <br />S <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Par accltlentl <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTY DAMAGE <br />Per accident <br />UM DRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />§. <br />EXCESSUM5 <br />CLAIMS -MADE <br />AGGREGATE <br />$ <br />DED I I RETENTION S <br />$ <br />m <br />A <br />WORKERS COMPENSATION <br />ANUEMPLOVERTUABILITY YIN <br />ANY PROPRIETOIUPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />(Mandotory in NH) <br />I DESCRIPTION <br />Ifw.,d ,I,A OF OPERATIONS below <br />NIA <br />1786318-18 <br />05/01/2018 <br />,J, <br />05/01/2010 <br />PER "OTH- <br />,STATUTE ER <br />EL EACHACCIDENT <br />8 1,000,000 <br />E.L DISEASE - EA EMPLOYEE <br />a 1,000,000 <br />E.L. DISEASE- POLICY LIMIT <br />1,000009 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 101,Additionol Remarks Schetlule,may ba attachedif more space is required) Ayt ° <br />The City of Santa Ana, licences, employees, agents, volunteers and representatives <br />Proof of Insurance <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />The City of Santa Ana ACCORDANCE WITH THE POLIOY PROVISIONS. <br />20 Civic Center Plaza <br />Santa Ana CA 92701 I <br />AUTHORIZED REPRESENTATIVE <br />©1988-2015 <br />All rinhm rncaev.d <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />