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ATE <br /> '4 CERTIFICATE OF LIABILITY INSURANCE D04/30/2025) <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 the <br /> 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 CONTACT <br /> Eddie Quillares Jr. NAME: Eddie Quillares <br /> State Farm Agency PHONE Eai,714.617.7150. AIC No:714.617.7158 <br /> E-MAIL <br /> 415 N. Broadway ADDREss:eddie eddie insurance.com <br /> ASanta Ana, CA 92701 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURER A:State Farm General Insurance Company 25151 <br /> INSURED ROmo Enterprises Inc. INSURER B:State Farm Fire and Casualty Company 25143 <br /> DBA DTSA Services INSURER c:State Farm Mutual Automobile Insurance Company 25178 <br /> 1191 La Limonar Rd INSURER D <br /> Santa Ana, CA 92705 INSURERE: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:75-0450 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 LTR TYPE OF INSURANCE ADDL SUBR Y <br /> POLICY NUMBER MMIDDIYYYY MM1DDffYYYY LIMITS <br /> A GENERAL LIABILITY �a 92-TA-M375-3 01/01/2025 01/01/2026 EACH OCCURRENCE S 2.000.000 <br /> X COMMERCIAL GENERAL LIABILITY OAMA E TO RENTED <br /> PREMISES Ea c':curTencel $ 300,000 <br /> CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 5.000 <br /> X Loss of Income PERSONAL&ADV INJURY $ 4,000.000 <br /> X Professional Liability GENERAL AGGREGATE $ 4,000,000 <br /> GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $ 4,000.000 <br /> POLICY PRO LOC $ <br /> JECT <br /> C AUTOMOBILE LIABILITY El FYI606 0191-F20-75 12/2012024 12/20/2025 E�" den SINGLE LIMIT $ 1,000,000 <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident)AUTOS AUTOS $ <br /> S HIRED AUTO X AUTOS NON-OWNED P.O. <br /> cRdent <br /> PR TY DAMAGE $ <br /> UMBRELLA LIAB OCCUR EIL EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTIONS $ <br /> B WORKERS COMPENSATION X WC STATU- OTH- 1,000,000 <br /> AND EMPLOYERS'LIABILITY YIN 92-TA-M894-3 01/01/2025 01/0112026 G ` LIMITS FR <br /> ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICEIMEMBER EXCLUDED? Y❑ N I A <br /> (Mandatory in NH) E.L.DISEASE-FA EMPLOYE $ 1,000,000 <br /> If yes,describe under <br /> E.L.DISEASE-POLICY LIMIT I $ 1,000,000 <br /> DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> DIgulty igned <br /> Cleaning,power washing,and litter maintenance services for the City's Fiestas Patrias event;Clean and Safe Services in Downtown Santa Ana Tu Tran by �`n <br /> City of Santa Ana its officers,agents,employees and volunteers are named as additional insured. Nguyen°2041 soss <br /> Additional Insured endorsement issued for certificate holder with Wavier of Subrogation and non-contributory <br /> Certificate of Insurance shall provide thirty(30)days prior written notice of cancellation <br /> APPROVED <br /> By Tu Tran Nguyen at 4:04 pm,May 12, 2025 <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Santa Ana,Attention: Parks, Recreation, and SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Community Services Agency ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 20 Civic Center Plaza M-23 <br /> AUTHORIZED REPRESENTATIVE <br /> Santa Ana, CA 92701 <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03-01-2012 <br />