Laserfiche WebLink
ATE(MMIDDIYYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE FD01/13/2026 <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 po[icy(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 ondorsement(s). <br /> PRaouceR Eddie Quillares Jr. State Farm Insurance Agency NAME cT ELIDA GARCIA CERVANTES <br /> 415 N Broadway PRONE :714.617.7150. FAX No:714.617.7158 <br /> Santa Ana, CA, 92701 <br /> A�DRess:ELIDA.GARCIACERVANTES.VAF5S3 STATEFARM.COM <br /> WSURER(S)AFFORDING COVERAGE NAIC M <br /> INSURER <br /> A:State Farm General Insurance Company 25151 <br /> INSURED DTSA Services INSURERS:Slate Farm Frre and Casualty Company 25143 <br /> 201 E. 4th Street INSURER C:State Farm Mutual Automobile Insurance Company 25178 <br /> Santa Ana, CA 92701 INSURER El <br /> INSURER E <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 /> ILTR EXP <br /> SRI TYPE OFINSURANCE {AD�DL5U�BR pOLiCY NUMBER MM DPOLID!'YYYY MM DDCY EFF YlYYYY LIMITS <br /> A GENERAL LIABILITY I y I I y I 92-TA-X644-7 01101/2026 01/0112027 EACH OCCURRENCE $ 2,000.000 <br /> X COMMERCIAL GENERAL LIABILITY l I DAMAGE ( RENTED <br /> PREMISES Ea occurrence $ 300.000 <br /> CLAIMS-MADE 1XI OCCUR MED EXP(Any one person) $ 5,000 <br /> X Loss of Income PERSONAL&ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 4,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> POLICY JEO LOC <br /> C AUTOMOBILE LIABILITY FYI FYI <br /> 606 0191-F20-75 01/01/2026 0112112027 accde tSINGLELIMIT $ 1,000,000 <br /> X ANY AUTO BODILY INJURY(Per persar) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) <br /> AUTOS AUTOS $ <br /> HIRED AUTOS L <br /> AUUTOSNMED PROPER <br /> Pe a cdentDAMAGE $ <br /> $ <br /> UMBRELLA LWB OCCUR El❑ EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ <br /> B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN 92-TA-Y451-8 01/0112026 01/0112027 OR IMITS X DER 1,000.000 <br /> ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 <br /> OPFICEIMEMBER EXCLUDED? Y NIA <br /> (Mandatory In NH) E.L.DISEASE-FA EMPLOYE $ 1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPFRAT)ONS!b,low E,L.DISEASE-POLICY LIMIT $ 1,000,000 <br /> El El <br /> DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> NAME OF DEPARTMENT:COMMUNITY DEVELOP EMENTAGENCY <br /> NAME AND LOCATION OF PROJECT:CLEAN 8 SAFE TEAM SERVICES IN DOWNTOWN SANTA ANA <br /> APPROVED <br /> By Tu Tran Nguyen at 8;45 am,Jan 15,202$ <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> COMMUNITY DEVELOPMENT AGENCY ACCORDANCE WITH THE POLICY PROVISIONS. <br /> ATTENTION: SAVANNAH SPICER <br /> 20 CIVIC CENTER PLAZA M-25, SANTA ANA, CA 92702 AUTHORIZED REPRESENTATIVE <br /> ! f� <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 />