THIS CERTIFICATI
<br />CERTIFICATE 001
<br />BELOW, THIS Ct
<br />REPRESENTATIVE
<br />IMPORTANT: if the cordfioato I
<br />the terms and conditions of the
<br />asri fioate, holder In Dan of such
<br />ODumm
<br />dour Insurance Services, LLC
<br />11 USA" Drive
<br />ortin9ton Beach, CA 92649
<br />92702
<br />AMUNTION ONLY AND CONFERS NO RIGHTS UPON THE C
<br />'rIVELY AMEND, EXTEND OR ALTER THE COVERAGE API
<br />NOT CONSTITUTE A CONTRACT BETWEEN THE 16SUING
<br />:ATE HOLDER.
<br />IL INSURED, the polloy(tos) must be endorsed. if SUBRGGfi
<br />may require an orniorsemont, A statement on this certificate
<br />not
<br />IOLOER. THIS
<br />'HE POLICIES
<br />AUTHORIZED
<br />THIS 1S TO CERTIFY THAT THE POLICI
<br />INDICATED. NOTWITHSTANDING ANY
<br />CERTIFICATE MAY BE ISSUED OR MAY
<br />EXCLUSIONS AND CONDITIONS OF SUCH
<br />EQUIREW,
<br />S OF IIlia,
<br />PERT,
<br />POCI
<br />URANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AS E
<br />TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WIT
<br />THE INSURANCE AFFORDED BY Itit POLICIES D=FkaEEO HEREIN IS
<br />LIMITS. SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />FOR THE POLICY PERIOD
<br />RESPECT TO WHICH THIS
<br />CT TO ALL THE TERMS,
<br />T
<br />TYPE eP1NSURANGD
<br />', POL Y Mumma
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<br />X COMNEIiCiAi.QENFAALLlARO.tTY X
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<br />X
<br />PHPKI970777
<br />HPKI076777
<br />PHPK1976777
<br />OSIOZ12010
<br />90/0212019
<br />OW0212019
<br />W0212020
<br />OSI62(2020
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<br />EACHOCCURREN
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<br />Is - 6,000,00
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<br />$ 6000,00
<br />OED X ON 1000
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<br />WORNERS COMPENSATION
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<br />ANY PROPRIETORIPAmNERFMCUTIVU N
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<br />Cybor Liability X
<br />&Ot EPLI , Xt
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<br />01/2912020
<br />10/1712020
<br />Per Occ
<br />Aggregate
<br />1,000,00
<br />1,000,00
<br />pBSORlPTION OP OPaRATroN9JLOGRTICNSfVEHi
<br />City of Santa Ana, its off io
<br />representatives are, named a
<br />of the named insured A this if
<br />Worker compansation waiver a
<br />cancellation for non-paymanti
<br />LES (AU
<br />rs
<br />do
<br />sub
<br />of ptamiwn,
<br />_
<br />oh ACORDig1,Add1u0,ml aanterNa Sahadulo;e more opaoa lc raqulmd)
<br />Onmp10yeas, agents, uolvntetire and
<br />0.7 icsnrads with respect to the operations
<br />ie Primary per the attached endorsement.
<br />ogation inc'iuded. 30 days notice of
<br />D
<br />rTERTIFICATIPRnt ORR I I KII/ WICU R,JANnnrnnLMATNIMAI fAmInu I
<br />City of $dnta Ana
<br />Rlak Managament Dlvlsi
<br />n
<br />!.r
<br />CACCORDANCE
<br />JJ11�pOULO ANY OF THE ABOVE DESCRIBBO POLI
<br />U 9 n BXPtRATRDN DATE THEREOP, NOTICE
<br />WITH THE POLICY PROVISIONS.
<br />IES BE CANCELLED BEFORE
<br />WILL BB Ota"EREo IN
<br />20 Civic Center Plaza, A
<br />Santa Ana, CA 92702
<br />Fir
<br />fS A H A.
<br />'l i Y 111
<br />. EPRESENTATNa
<br />ED 4
<br />W TB16•2010 ACURU CORPORATION, All rights reserved,
<br />ACORD 25 (2010104) The CORD name and logo are registered marks of ACORD
<br />I
<br />
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