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FRESH-1 OP ID: HM <br />A4CoRa CERTIFICATE OF LIABILITY INSURANCE <br />DATE 6/01 2020 ) <br />osrovxo2o <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 A 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 policylles) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, Certain policies may require an endorsement A statement on this certificate does not confer rights to the <br />certificate holder In lieu of such endorsemen s . <br />PRODUCER <br />Golden Empire Insurance Agency <br />28720 Roadside Dive Ste. 376 <br />Agoura Hills, CA 91301 <br />GreyDahl, Inc. <br />OMACT <br />NAME;- <br />F <br />INC,No: <br />AooP1REss: <br />INSUR S AFFORDING COVERAGE <br />NAIL a <br />INSURER A: Continental Casualty Company <br />INSURED Fresh Beginnings Ministries <br />968 Presidio Dr. <br />INSURERS: <br />Costa Mesa, CA 92626 <br />INSURER C: <br />INSURER D: <br />INBUREN E <br />RUI ERF: <br />COVERAGES CERTIFICATE NUMBER: 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 MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />L48R <br />Im <br />TYPE OF INSURANCE <br />ADM <br />POLICY NUMBER <br />YEFf <br />MMI D <br />L ICYEXP <br />N <br />LIMITS <br />GENERAL LNML <br />EACH OCCURRENCE <br />S 1,000,00 <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE QOCCIRi <br />X <br />6011884990 <br />12/1912019 <br />12/1912020 <br />PREMISES teaam.nenca <br />$ 300,00 <br />LED EXP(A, onn person) <br />E 10,00 <br />PERSONAL a ADV INJURY <br />$ 11000,00 <br />GENERAL AGGREGATE <br />$ 2,000,00 <br />GENL AGGREGATE <br />LIMIT APPLIES PER: <br />PRODUCTS - COMPIOP AGO <br />S 2,000,00 <br />X POLICY <br />7 PRO- <br />IFCT LOC <br />S <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />E n. <br />S 1,000,o0 <br />BODILY INJURY(P. person) <br />S <br />AIANY <br />AUTO <br />6011894990 <br />12119/2019 <br />12/19/2020 <br />ALL OWNED SCHEDULED <br />BODILY INJURY (Per a .ft) <br />S <br />HIRED AUTOS X �DSWNm <br />p HA �DEAMA <br />S <br />s <br />UMBRELLA LUB <br />OCCUR <br />EACH OCCURRENCE <br />S <br />AGGREGATE <br />i <br />EXCESS DAB <br />CWMB-rMDE <br />DEO I I ReTNT N <br />S <br />WORXERB COMPENSATION <br />WC STATLb JOTH• <br />FR <br />AND EMPLOYEWLIABILITY YIN <br />ANYPROPWETORMARTNER,EIECUTIVE 0 <br />OFFICERNEMBER EXCLUOWT <br />NIA <br />EL EACH ACCIDENT <br />-- <br />S <br />E.L. DISEASE - EA EMPLOYEE <br />S <br />(MenEAtory In NMI <br />Nyyee, Cxmbe unEer <br />DESCRIPTION FOPERATIONS Wbw <br />E.L. DISEASE -POLICY LNIT <br />13 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANP:h ACORD 101, ANellonal Remeds SOIMJulo. N more space is repulret!) <br />City of Santa Ana., officers, agents, asnployees, and volunteers are named as ✓ <br />additionally insured on this policy pursuant to written contract, agreement, <br />or memorandum of understanding. subject to attached form SB1469321F. <br />•ee30 Day Notice of Cancellation. <br />REVIEWED & APPROVED <br />By Risk MANAGEMENT DIVI510N <br />CERTIFICATE HOLDER i CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City Santa Ana — - <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />of <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Division ANGiE ACEVEdo <br />20 CIVIC Center Plaza, 4th FI, <br />AUTHOWEED REPRESENTATNE <br />%� <br />Santa Ana, CA 92701 <br />C 1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />