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ACoR ® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD[YYYY) 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 ADDITIONAL 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). GONTACT PRODUCER NAME:. COMPLETE EQUITY MARKETS INC 1190 Flex Court Lake Zurich, IL 60047 Complete Equity Markets Insurance Agency Inc (CASL#OD"077) t547 541-uaUu Alc No: o4r D4I-U'+'+'F E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC fk INSURER A: National Specia4 Insurance Company INSURED Elio Palacios, Jr. 7121 Magnolia Avenue Riverside, CA 92504 INSURER B : INSURER C : INSURERD: INSURER E : INSURER F : 01=wIcInId KINIMRIPP. LVYCf\MVLJ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY 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. INSI LTR TYPE OF INSURANCE ADDL imqn SUER wvD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES LEa occurrence $ CLAIMS -MADE OCCUR MED EXP IAny one person) $ PERSONAL & ADV iNJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S PRODUCTS - COMP/OP AGG S RPROJECT � LOG POLICY � S OTHER. AUTOMOBILE LIABILITY Ea accident) DSINGLE LIMIT S ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) S AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident S S UMBRELLA LIAB .00CUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAB CLCMS-MADE DIED RETENT IONS S WORKERS COMPENSATION ER _ TE ER STATLITE E. L. EACH ACCIDENT $ AND EMPLOYERS' LIABILITY Y f N ANY PROPRIETORIPARTNERIEXECUTIVE E.L. DISEASE - EA EMPLOYE $ OFFICERIMEMBER EXCLUDED? ❑ (Mandatory in NH) NIA E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below A Professional Liability JQF 1804285 02101124 02101l25 Each Claim Aggregate $1,000,000 $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Subject to all policy terms, conditions, exclusions and endorsements. The City of Santa Ana is listed as an additional insured but only per the terms and conditions of the endorsement generated and subject to all policy terms, conditions, exclusions, and endorsements. TE HOLDER I IVN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF NnTtr.F VUH I FIE nFI IVFRFn IN ACCORDANCE WITH THE POLICY PR( City of Santa Ana RkkManagemadDMffb n Risk Management Division AUTHORIZED REPRESENTATIVE is REVIEwm & APPRovED [I : 20 Civic Center Plaza Aetvda Santa Ana CA 92702 II Management Specialist ©1988-2015 ACORD ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD