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ORANCOU-03 HPIETRAFRITTA <br /> CERTIFICATE 4F LIABILITY INSURANCE DATE{M <br /> siz71202YYY) <br /> zozs <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 have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> NAME: <br /> Bender Insurance Solutions PHONE FAX <br /> 516 Gibson Drive (AIC,No,Extls(916)380-5300 (A/C,No):(916)380-5206 <br /> Suite 240 E DAIL <br /> Roseville,CA 95678 INSURERS AFFORDING COVERAGE NAIC N <br /> _.._._ INSURER A:Accident Fund Insurance Com any 10166 <br /> INSURED INSURER B: <br /> Orange County Children's Therapeutic Arts <br /> 2215 N Broadway INSURER e <br /> FI 1 INSURER D: <br /> Santa Ana,CA 92706-2664 INSURER E <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER: 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 ADDLTSUBR7 POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE IN SD I VVVp I POLICY NUMBER (MMIDOMM.) IMM100NYYYI LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE R$ <br /> GLAIMS-MADE LJ OCCUR DAMAGE TO RENTED <br /> PREMISES Ea rrence $ <br /> IVIED EXP(Any onePerson) $ <br /> PERSONAL&ADV INJURY $ <br /> GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ <br /> POLICY1-1 JECT PRO- LOG <br /> PRO- <br /> PRODUCTS-COMPIOP AGG $ <br /> OTHER: I $ <br /> AUTOMOBILE LIABILITY GOMBIry-0 INGLE LIMIT <br /> Ea accident $ <br /> ANYAUTO BODILY INJURY Perperson) $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS i BODILY INJURY Per accident) $ <br /> HIRED NON-OWNED PROPERTY <br /> DAMAGE <br /> AUTOS ONLY AUTOS ONLY Peraccident $ <br /> i <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ __ <br /> EXCESS UAB CLAIMS-MADE AGGREGATE <br /> DED RETENTION$ <br /> A WORKERS COMPENSATION X PER OTH- <br /> AND EMPLOYERS'IIABILITY YlIV STATUTE ER <br /> ANY PRO PR ETORIPARTNERIEXEC UTIVE �( CW WCP 1U0146747 6I512026 615�2027 1,000,000 <br /> OFFICERJMEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ <br /> (Mandatary in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) <br /> RE:All CA Operations <br /> APPROVED <br /> By To Tran Nguyen at 2:43 pm,May 27,2626 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> City of Santa Ana AUTHORIZED REPRESENTATIVE <br /> ATTN:Audrey Goodson <br /> 801 W.Civic Center Dr.Suite 200 I/ ?1y�t.�Vd <br /> 'Santa Ana CA 92701 <br /> ACORD 25(2016/03) UV�� ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />