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ACORO� <br />�- CERTIFICATE OF LIABILITY INSURANCE DATE(MM/pp7YYYY) <br />-- 11 /22/2019 <br />THISCERTIFICATE IS ISSUED AS CMATTER OVERAGOFINFORMATION BY <br />ONLY AND CONFERS no RIGHTSUPON THECERTIFICATE HOLDER. THIS CERTIFICATE DOES NOTAFFIRMAnVELYOR NEGATIVELY <br />AUTH O, AUTHORIZED <br />EMNO RE ALTER REPRESENTATIVE <br />COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE GOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(SL <br />AUTHORI2ED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER <br />IMPOgTAM:IRhe cerRRCYIa hOltler la an ADOITIG.. a INSUREDhen Palirypes)mU" have ADOInONAL INSURED praWide rs ar be eademed. If SUBROGATION Is WAIVED, subjec! Re LLe Lerms and <br />contlitians al the pollc%certain polidesmay require an enrlorzemenl p zLitemnnl on Ihls ceN1R�[e tloes notconterrlgh6lo the <ertiBcase hW der in Iluu of m<hWAIVE ement(al <br />PRODUCER - - <br />CONTACT <br />Kalhy Lamm(975534FI) NAME: <br />2915 Red Hill Ave Ste F201 PHONE FAx - — <br />A/C. NO.866-416-8939 (PIC. ND1: 866-416-8939 <br />E-MAIL --- _ _ _. <br />Costa Mesa CA 9262&3428 ADDRESS: klamm(djfarmersagenLwm <br />t1ISVRED - _ - INSURER I AFFORDING COVERAGE NAII <br />INSURERA Truck Insurance Exchange -' <br />INSURER& Farmers Insurance Exchange _ ?1709 <br />DINH. JANIES _ _ 21652 i <br />STUDIOFOLIA uuupsac Mid Ce_nlury Insurance Company 21687 <br />12723 PARK ST INSURERD: <br />CERRITOS CA 90703 INSURERS- <br />INSURERF; -' --• - - _ _ . <br />COVERAGES CERTIFICATE NUMBER: - <br />RPIISIONNUMBEFE <br />IRIS IS TOCER IFY fHgl IHE POLICIES Or IMURAHCE USIED BELUIV NAYS a,LIR SSUED IU IHE IFISUnEU nAh1E ApOVE Nn IrE •YIUC-r P[RIOU UIOIGATEO VgDyrtubi,V IDIN6 ANY <br />POUCIEEAAEN RIPIEDHEAEINRII NOHOF IaULINI'CA E OTHER1CNSAHQCOVITIIfl ESpECr TO4VFRLIITHIS CERUFIGArE MAftlE ISSUED OR MAf PFRrgIN tNE INSiIRAL:GE gIhORUE09'l RIF <br />PfiUC:ES DESCRIaCO NEdfIM'S iUDIEU rp aLL IME rERMS, EYCLU510Ni qN0 CONpIT10fRrlP SUCH VpDCIEi. LIMBS CHOWII AqY I WVE BEE41 MAYPE LI DF PAID M II <br />IMS <br />Ian TYPEOFINSURANCEDM - "—" <br />VR IN O Mo POLICYNUMBER POUCY EFP POLICY"P <br />(MM/DO/YVN) IMM(OD/YYYYI LIMITS <br />�S/ .1 COMMERCIALGEMEML1ABILITY -- — --- <br />.c1__ = 0 _. <br />EACH a[uRRE5 <br />CNu\V..npAOE Q00 <br />MIT 1,OO <br />X aCCUF DAMAGEtORENTEO � — <br />PREMISES(Eapcamrancel S 75.000 <br />A <br />MEDExPtm,000ryare vnon) 5-.. - -_ Y Y 605513299 02(0112020 02/01/2021 PERSONAL BpDv requgv - _ <br />,EH L AGGAEGAI EUMII aPL'!i ES+E,, XI auur.! 1,000A00: <br />HERALAGGREGAYE <br />rar�lE; 1 uB. GE _ 2.000,000 <br />UPER <br />aNODNG COMPIOPAGG i 1,000,000� <br />ALDOMOBI,�LIABIUTY _- -- -- _OM iNED"IPIGLEUM" B 1,000,0001 <br />AMY <br />OWHLU AU W`- SCIIEUULNr BUOILI INJUR'/i Per Pf_,•tanl r5 <br />A ONLY ADf 1p 605513299 ROmUINIURVTP•-'acodcy,U �s <br />HIRLDAUTOS X NIN.OmhfO 02701/2020 OZl0112021 <br />"Ntr AnI oral PP.nPER1Y Dai <br />- mer ttadenu ' <br />UMBRELLALIAB 01Y UP <br />MCI.00IURHENLt <br />EECFSS UAO !'AMIi2N::E <br />- AGGRLGATE <br />OED R1'rNu0Nf <br />WORKEP.SCOMPEN5ATION - - - - -- _ _ ',S <br />ANDEMPLOYERS-LIAMLITY PER + <br />ilarU L �'II ILN -i <br />ANY PROPRIETOR, 01FiR(PARI.MR. nx <br />ECECUDED'Ma£R;M¢MHFN - Nrq EL EACHa�UOFNF <br />ifye.J,e eve[IrtDF C NMI LL OLS SL Eq EMPbhEE < II PER Uesaiheanrizr DESCRIPnpN OF <br />OPEHMIONS hu!vn - _ - -- <br />EL CIiFAiC P(1LILV Llhll l j <br />1 <br />DESCRIPTION OFOPEBATIONS/LUCATIONSIVEHICLFS (ACORD IOR,1WJitianal Renmrxs5cheduln, ma% he aRachetl ilmore zpae isrequired) - <br />t'2723 PARK Si, CERRITOS. CA 90703 THE CITY OF SANTA S, EMPLOYEES AGENTS AND VOLUNTEERS HAVE BEEN ADDED AS <br />, <br />BAN ADDITIONAL INSURED VIA A PRINIAR0"ElY&AVIAMBEIVIENT 30 DAY NOTICE OF CANCELLATION <br />_ BY RISk MANAC{EMENT DIVISION <br />CERTIFICATE HOLDER re P ANCELIATIOFI <br />- - - CITY OF SANTAANA <br />SHOULOgL1YOFTHEgBOVE DFSCpmEp POLICIES 20 CIVIC CENTER PLAZABECgNCE�LED BEFORE THE "PIRATION <br />D THEREOF, NOPCE WILLS BEG IN pCCOROAITCEWITH THE POLICY PROVISIONS. <br />AuiHON12ED REPP - AT1VE� i : x - -""-- - <br />- SANTAANA_. <br />r <br />ACORD 25 (2016/03) 11 1769 I Ii t 19AB-2015 ACORD CORPORATION, All Rights Reserved <br />The ACORD name and logo are registered marks of ACORD <br />