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A1CdRQ® <br />�..r CERTIFICATE OF LIABILITY INSURANCE <br />DATE 1312022Yj <br />o1i�siza�2 <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 INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT. If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 endorsement(s). <br />PRODUCER <br />JOSE GASTEI_UM, AGENT LiC# QD10779 <br />STATE FARM INSURANCE <br />5tatel=arr►t 1780 E MCFADDEN AVE STE 114 <br />WW SANTA ANA CA, 92705 <br />CONTACT NAME: Jose Gastelum, Agent <br />AHCNNa xt •7t4-557-3344 we No :714-327-0198 <br />ADDRESS: Jose.gastelum.L8LS@statefarm.com <br />INSURER(S)AFFORDING COVERAGE <br />NAIC N <br />INSURER A :State Farm Mutual Automobile Insurance Company <br />25178 <br />INSURED <br />INSURER B : <br />INSURERC: <br />SLS PROPERTY SOLUTIONS, INC. <br />INSURER D : <br />919 E SANTA ANA BLVD <br />INSURER E: <br />SANTA ANA, CA 92701 <br />INSURER F : <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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADIDL <br />SuBR <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDIYYYY <br />POLICY EXP <br />MMIDDNYYY <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />S <br />CLAIMS-MADE OCCUR <br />DAMAGE TO RENTru- <br />PREMISES Ea occurrence <br />S <br />MED EXP (Any one person) <br />$ <br />PERSONAL & ADV INJURY <br />$ <br />OTHER: <br />$ <br />A <br />AUTOMOBILE LIABILITY <br />Y <br />535 5136-F01-75C <br />12101/2021 <br />06/01/2022 <br />Ea MEIN ecudent SINGLE LIMIT <br />S 1,000,000 <br />BODILY INJURY (Per person) <br />S <br />ANY AUTO <br />473 3354-F13-75F <br />12113/2021 <br />06/13/2022 <br />BODILY INJURY (Per accident) <br />S <br />ALL OWNED X SCHEDULED <br />AUTOS AUTOS <br />NON -OWNED <br />x HIREDAUTOS X AUTOS <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED I I RETENTIONS <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y 1 N <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYE <br />S <br />OFFICERIMEMBER EXCLUDED? ❑ <br />(Mandatory in NH) <br />N 1 A <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />A <br />2006 Ford F250 SO <br />1FTSX21P96EB68260 <br />Y <br />5355136-F01-75C <br />12/01/2021 <br />06101/2022 <br />2000 Ford F150 Pickup <br />1FTZX1728YN861176 <br />473 3354-F73-75F <br />12/13/2021 <br />06/13/2022 <br />DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) <br />Agreement number: A-20147-219 <br />City of Santa Ana, its officers, agents, and employees and representatives are named as Additional Insured as respects With AUTOMOBILE LIABILITY for <br />services provided by the named insured. Coverage is primary and non-contributory <br />30 days notice of cancellation applies. <br />CERTIFICATE HOLDER CANCELLATION _ <br />CITY OF SANTA ANA <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />RISK MANAGEMENT DIVISION <br />THE EXPIRATION DATE THEREOF, <br />NOTICE WILL <br />BE DELIVERED IN <br />20 CIVIC CENTER PLAZA, 4th FLOOR <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />SANTA ANA CA, 92702 <br />AUTHORRED <br />REPR ENTATiVE <br />01988-2014 AC C <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />F <br />` <br />1°F <br />R`s`�Dt`�101L <br />REVIEWED & APPROVED BY.- <br />��/ <br />i <br />-- <br />Risk Management Analyst <br />