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. on DATE(MM/DDIYYYY) <br />CERTIFICATE OF LIABILITY INSURANCE 07/23/2024 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br />THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE <br />POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), <br />AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, <br />subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not <br />confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER CONTACT <br />FARMERS GENERAL INS AGCY INC/PHS NAME: <br />47180001 PHONE (86) 7- 7ftoa <br />(A/C, No, E 7): <br />The Hartford Busines ervice Center <br />3600 Wiseman Blvd i <br />E-MAIL <br />Sann ri <br />San Antonio, TX 7ADDRESS: <br />8 1 <br />I U (S) FF IN R NAIC# <br />Justin Phu dba Justin Phu Media <br />1255 E VISTA WAY # 114 <br />VISTA CA 92084-4039 <br />COVERAGES AV - r LRWUPFIC4WF NLJISOM- NO <br />INSURERF <br />HartfoM Casu <br />INSURER : <br />INSURr C <br />mpany <br />REVISION NU""BER- <br />THIS IS TO CERTIFY THAT THE IES OF CE LISTEP F -)W HAVE BEEN ISS14ED <br />4DiTION OF ANYF s I PH PD <br />ANY OYUPERTA <br />DOMAYT <br />A ORETHE <br />I�� EHI <br />EONS <br />BE ISSUED ORCMAING BON <br />NTNTHFMNSUCBNCE AFFORDED BY <br />CERTIFICATEDC <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLIr .ES. L' ITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR TYPE OF INSURANCE ADDL SUBR P' -.CY NUMBER POLICY EFF POLICY EXP LIMITS <br />LTR INSR WVD MM/DDIYYYY MMIDD/YYYY <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />CLAIMS -MADE ❑OCCUR <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />MED EXP (Any one person) <br />PERSONAL & ADV INJURY <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />POLICY1:1 PRO- LOC <br />JECT <br />PRODUCTS - COMP/OPAGG <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />BODILY INJURY (Per person) <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) <br />HIRED NON -OWNED <br />PROPERTY DAMAGE <br />AUTOS AUTOS <br />(Per accident) <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />EXCESS LIAB <br />CLAIMS- <br />MADE <br />AGGREGATE <br />DED <br />RETENTION $ <br />WORKERS COMPENSATION <br />X <br />PER <br />OTH- <br />AND EMPLOYERS' LIABILITY <br />STATUTE <br />ER <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />ANY YIN <br />A <br />PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />NIA <br />X <br />47 WEC AB809W <br />07/26/2024 <br />07/26/2025 <br />E.L.DISEASE -EA EMPLOYEE <br />$1,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />E.L. DISEASE- POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Those usual to the Insured's Operations. Blanket Waiver of Subrogation applies in favor of the Certificate Holder per the Waiver of Our Right to <br />Recover from Others Endorsement WC040306, attached to this policy. Notice of Cancellation will be provided in accordance with Form WC990528, <br />attached to this policy. <br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />20 CIVIC CENTER PLZ BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br />SANTA ANA CA 92701-4058 IN ACCORDANCE WITH THE POLICY PF <br />AUTHORIZED REPRESENTATIVE Risk MaugmuxtDMslcrn <br />REVIE WED & APPROVED BY. <br />© 1988-2015 ACORD COF Risk Management Specialist <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />