|
DA'ff! l!AMt[lDfnYYl
<br />11/1/2024
<br />TH18 GE!rlTli'lCA'fi! 18 188UaO A8 A ffiATTarl OF INFOflMATlON ONLY AND 00NPER8 NO RIGHT8 UPON THE CBRTIPIOiTE! HOLDER, THIS
<br />OERTIFIOATE DOnEl NOT AFPIRI/IATIV €LY OR NBGATIVELV AaMENO, BXTffND OR ALTffR THEi COVffRACffl APPOROEiD B/ THB PO1101E8
<br />BEIOW, T1118 0ERTIFICATf. OF lN8URANOEi DOE8 NOT 00N8TITUT5 A CONTRACT BEn/VBBN THEI 188umG INEIUFIER(8), AUTHORIZBD
<br />RffPRl8ffNTATlV5 0R PROOuCBR, AND TIIB OBRTIFIOATEI Halt)un,
<br />IMPORTANTi If Ilio codlfioato lioldor Iti an ADDITIONAl lN8URtlD, elm liallay(Ion) muat liave At)DITIONAl 1N8URED provlttlomt or I)O ondorgad,
<br />If 8uBROGATION 18 WAIVED, suliJoat to lho terms nnd titindlllona of tlio polloy, corlaln 1}0110108 may vaqulro an ortdorsornorit. A alaloinant on
<br /> llilaoorllTk,alodooaiiotconfarrlghlstalliacerllllcnlolm}dorlnllauolauahondorsamanl(s).
<br />a!;116ffuaaR r4o7e: !787j8822:il2
<br />Aliollo (!enomf lniiitanea%onay, Ino. (})
<br />P, 01 BOX 1508
<br />Sonoma, Collrornlu 95476
<br />i ii
<br />Ifi0r,:lor JcilleoCnrpanler
<br />iij
<br />ti i;i51)n.ffJlt IIX)!!-tlolt
<br />t
<br />/
<br />i;
<br />It f'l!Nttisi""""'jeillaac@apBen.com -
<br />IN81lR!R(a)AFPOll[llllO COV[!(JAG(l NAIO #
<br />It,sun,nA, Niiutllus tiigiimnco Company 17170
<br />rNsullE0
<br />J&G Induslrlos, lno.
<br />18627 Brookliural Straot
<br />PMn 302
<br />Founlaln Valley, CA 92708
<br />lll4ullfflIDl 1(oyItlsklnsumnceCoinpniiy 10885
<br />1)lgHll@ll@, Slii(oComlieiisiillonliisurnnccFund(XCiillrornlu35076
<br />INlUnffrl()i Toldo Mndno AinetlanInsurnrica Co 10945,
<br />1118ujleRffi
<br />!llaUllffRPl
<br />covaba.s CE!RTIPICATB NuMBE!Ri 1493 RBV1810N NUMBEFli
<br />THIS IS TO (ffRnF'l TMr THff POLlOlff8 0F IN9URANC5 LIST6D BEIOW HAVB DBEiN IS8UEiD TO TH5 lN8URgO NAM€D MOVF. FOR THff POLICY PERIOD
<br />INDIOATED. NOTWffH8TANDlNa ANY n[:aLllREM(:NTi TERM OR GONDITION OF ANY 00NTRAOT OR OTHER DOCUMENT WITH rlE8PEOT TO WHICH TH18
<br />OfftltlFIOAT € MAY fit; 189UP0 0R MAY 11ffnTAlN, THff INSURANCE AFFORDffD B'l THE POLlOlff8 DE!%RIBEO HEREIN 18 SUBJ[:OT TO All THff YEnMl,
<br />E €OLUEllON8ANDOONDITION80F8UOH('OLIGIE8.LIMITgeHOWNMAYHAWDttBNI(BDu0fiDB/ ?A1DOLAIM8
<br />'ff!WPtl OPlllaUtUlllatl AOtll
<br />INRD
<br />6tlllil
<br />WVO IIOLIO'/llUMllffn !m8)!Ml !tab!%Ktli lj&llai8
<br />A
<br />/
<br />-V
<br />COMM!RCIALOnlHllUllLlAulLITl
<br />](1A1M8.)Muff (E] O(ICUI}
<br />Profossloiinl $1,000,000 /Y
<br />[.CP2038906.12 I1/1/202-1 11/1/2025 gxcngte3inn4qq@ I I,000,000
<br />I)A
<br />)p!!i(
<br />ili
<br />It
<br />IIi!'(l
<br />I li
<br />flGffl
<br />tlaoia
<br />iD
<br />'noml , iOO,OtlO
<br />Afl:OEXP(Ai0 6% potion), 5,000
<br />t!_RBONAta AOVIHlUtl'/s 1,000,000
<br />0!l!i./laOTlaaATa(IMIT Ar'PLlff8P!lti
<br />epoolrHiEo;[26 []coo
<br />a!!NeRAL Aa(171!GATE!s 2,(100,000
<br />pnonuora .CO)AP{O))AaG , 2,GOD,0(IU
<br />Polliilion a " 1,000,(100
<br />n AU-01AOnll!LlMllllff
<br />ANY AtlTO
<br />- owugo j71 4c+igtiuu:o._ AUTO80NLY LJAUIOII,/ Hlnao h/l NoN4WNEH__ A11TO80N1Y AUTO80Nli
<br />U!Y
<br />UAI)2041776-1 l 11/1/2024 11/J/2025 );0,:9JgJlltt(lLffffltlTs 1,000,000
<br />OODIU/ INJURY(Parpoiaon)e
<br />DODIIV INJURY (Par amdanr)a
<br />j,i,9j,,Hng, g/MIAaff *
<br />*
<br />A -4/
<br />11MUlu!!tALlA8
<br />5X(:aa81MD
<br />/CR:CUR
<br />CUllM8.AlAt)g
<br />v v
<br />11FX2038907-12 11/1/2024 It/1/2025 pair occunns+ica $ S,000,000
<br />Aa(lR€(lATa $ 5,000,000
<br />tit.ol Inaiem.one s
<br />c
<br />WOFIH!!Ra(,OMt'eN8AllD)1
<br />AND 5Ml'lOVlRa' 114(llLlrV y) 10AHW"ROPRlaTORIPARTNW!)lEallTIVff n
<br />OPPI(fi!UM!llJtl!RaX(lkuOEt)? It
<br />(Atandaloiyln HH)
<br />o!'A?lfliot'ff!!i i'fA pg*yio+isboiow
<br />)1/A Y
<br />9346758-24 10/1/202-1 10/1/2025 "1 €!'J%ngl lo-?'
<br />ff.l, Cjlq0 A(I(IIDIAff , 1,000,000
<br />B.l.Dl8fl8B-U EMPLOYEEI l,DOG,UOO
<br />E.l. D18EA8E - POLICY LIMff s I,€lOO,(100
<br />D {nlnndMnslno (Conimaroliil)4/y a'll6-112447.00 11/1/2024 11/1/2025 Rtntidltau& Peimm
<br />R<nliil: PuOltiingni*
<br />150
<br />'75€
<br />offisllillpnollO#opanAyioNsllo(l/lTloNs/vallN)tea P(I(NlClaliAddllloiial)%miika8ohadiilo,'maybi;Ilieli;d'llmoi>;pualinquTt'iil)
<br />Rf) I "OemolLtlon 8sxvlcas on all @n<all basla IlffP 22-00?" - Operations at' tllO ))amad :tnau)'ad - aft)/ eA 8arlta Anal itO
<br />offlaaxat OalAIBl emplOyeoa, and voluntelll)Ca ate liexoby nomod as Addltional Insu):edi it tequl)and bp W).lUt(in
<br />aolll:taal5 pet endo)eaomant ht)laet<li WalVOr Oe 8ubrogatlon 16 p!OVldadi aa lasqullaed bV Nrltt9n aont)ta0t vlth the lnallted
<br />aa roapaatii aovarago ovidiinaod heteln.
<br />[0):m tO tml undelalylng GOllOLaal Llabllltayoi vCa0"laaal'a(TaOvlaldl:nauat.dO haana"ovl"orhLe:pa'clmonarp"yonal)nadbinoollncooovon:41"g'ba"i 'AoiO' -EdaXa7olale):11tat(!nxonlOlot'l(Rl
<br />ahall be mallod to bha aaxbl)!laaue holder at bbo addtaas provldod hoxein, ahould a dasajlbod poliay(s) be canaol)tid
<br />bafoxo tliti expiration date tlisxeoei 20-day notlca lot non-paymont of premlumi
<br />(J!RTIPIOATEI HOLDE!R
<br />Hokle!sNnltira orln(otoal :Addltionul [iiiured
<br />City of'Snn(ii Ana
<br />20 Clvla Center Pltiza M-30
<br />8nnlaAnn, CA 92702
<br />l,,,,,,
<br />8HOuLO ANYOP Tm! ABOVff ffil8(1111980 f'e}1101(!8 5ffl O/lNaffllEID WOnff
<br />TAHcnoOERXoPAINRoA!TIW01NTHDTAHT:Po?lHloByR:tnOoP,18NlOoNTl80ff WILt Off DIll.lVffft5D IN
<br />4111110!It!t!DllnPllDl7/,YilVqa ,..
<br />ACORD 28 (2016/03)
<br />CANC!fiLlATION
<br />0l00840"l5AOOROOORPORATION, Allrlghtsreservod.
<br />Tlte A00RD name and loan are registered marks ofACORD
<br />
<br />
<br />City Council 20 – 224 4/15/2025
|