RODRIGUEZ, LUIS J. - Laserfiche WebLink

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F10ERTIFICATE OF LIABILITY INSURANCE Date on o/zoza THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). ADMINISTRATOR CONTACT Special Event Department Hub International Insurance Services, Inc 3000 Executive Parkway, #300 PHONE (925) 609-6500 1 FAX (925) 609-6550 E-MAIL specialevent@hubinternaticnal.wm San Ramon State: CA 94583 INSURER(S) AFFORDING COVERAGE NAIL # License Number: 0757776 INSURER A: Colony Insurance Company 39993 INSURED INSURER B: Luis Rodriguez See Full Named Insured Schedule INSURER C: INSURER D: 716 Orange Grove Avenue San Fernando California 91340 INSURER E: INSURER F: COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE AND INSURED MEMEBER ENDORSEMENT LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSURED COVERAGE LIMITS LTR MEMBER ENDT EFFECTIVE/ NUMBER EXPIRATION DATE A ❑J COMMERCIAL GENERAL LIABILITY 24012311 10/25/2024/ EACH OCCURENCE $1,000,000 ❑❑ CLAIMS -MADE ❑J OCCUR 10/27/2024 DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 ❑ MED EXP (Any one person) $5,000 ❑ PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE APPLIES SEPERATELY TO THE NAMED INSURED AS PER ATTACHED ENDORSEMENT T7523-0111 GENERAL AGGREGATE $2,000,000 PRODUCTS — COMP/OP AGG 2 $ ,000,000 LIQUOR LIABILITY PER WA OCCURENCE (AGGREGATE INCLUDED IN GENERAL LIABILITY AGGREGATE) MASTER POLICY NUMBER: 103 GL 0212472 01 EFFECTIVE DATE: 2024-01-01 EXPIRATION DATE: 2025-D1- 12:01 A.M. Standard Time at your Mailing 01 Address DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) The certificate holder is included as Additional Insured as per endorsement T5409-0118. This insurance is Primary and Non -Contributing as per endorsement CG 2001 1219. The insurance company waives rights of recovery as per endorsement CG 2404 1219. The Insured Member Endorsement cannot be cancelled by the Insurance company as per endorsement T1523-0111. Named Insureds as per Full Named Insured Schedule. Event Type: Vendor/Caterer/Exhibitor Event Locations: 26 Civic Center Plaza Santa Ana California 92701 See Full Location Schedule CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY 20 Civic Center Plaza PROVISIONS. Santa AnA California 92701 R,.A,e eAn2 AUTHORIZED REPRESENTATIVE g