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s <br />/ �wM QLRTIFICATE OF LIABILITY INSURANCE <br />008/16/ 0/16 <br />INSURANCE <br />08 /iG /201G <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, � i P,U8R"AT, NY- .WAIVED, subject to the <br />terms and conditions of the Policy, certain policies may require an endorsement. A stater d`(R 4.Jiirtific�te `does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER Eddie OUlllares Jr. <br />State Farm Agency <br />415 N. Broadway <br />Santa Ana, CA 92701 <br />1rvsuRED DOWNTOWN INC <br />200 N MAIN ST FL 2 <br />TACT <br />NAME: Eddie Qufllar <br />PRONE 714.81 <br />EMAIL <br />ODREs : eddie eddi n§ hh8e.com <br />INSURER 5 AFFORDING COVERAGE <br />NAIC k <br />INSURERAI State Farm General Insurance Com an <br />INSURER B; State Farm Fire and Casualty Com an <br />_ <br />p <br />43 <br />INSURER C: <br />NAMED ABOV�EE OR <br />SANTA ANA CA 92701 <br />INSURER D <br />PERTAIN, <br />INSURER E; <br />NSURER F: <br />DOCUMENT WITH RESPECT <br />COVERAGES CCaTIOrA TC <br />TI <br />THIS IS TO CERTIFY THAT THE POLICIES <br />OF <br />INSURANCE <br />LISTED BELOW HAVE <br />F <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, <br />BEEN <br />TERM OR CONDITION OF ANY <br />ISSUED <br />CONTRACT <br />TO THE INSURED <br />NAMED ABOV�EE OR <br />THE POLICY PERIOD <br />CERTIFICATE MAY BE ISSUED OR MAY <br />PERTAIN, <br />THE INSURANCE AFFORDED <br />OR OTHER <br />DOCUMENT WITH RESPECT <br />TO WHICH THIS <br />EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. <br />BY <br />LIMITS SHOWN MAY HAVE SEEN <br />THE POLICIES <br />DESCRIBED <br />HEREIN IS SUBJECT <br />TO ALL THE TERMS, <br />IN7R SR <br />REDUCED BY <br />PAID CLAIMS. <br />TYPE OF INSVRANCE <br />ADD <br />POLICY NUMBER <br />POLICY EFF <br />MMIDD <br />POLICY EX <br />M Oh Y <br />UNITS <br />A GENERAL UA9ILltt <br />X <br />Y <br />Y <br />92- CE -0933A <br />06106/2016 <br />0610512017 <br />EACH OCCURRENCE <br />f 1,000,OCO <br />COMMERCIALCENERALUABIU TY <br />A <br />PREMISES Ea acunrencel <br />$ 300,000 <br />CLAfMSMAOE 1-x—] OCCUR <br />MED EXP (AnV me person) <br />S 5,000 <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />GENERALAGGREGATE <br />$ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS- CC MPIOP AGO <br />$ 2,000,000 <br />POLICY PRO <br />LOC <br />'NGL -EMIT <br />Ee <br />$ <br />T <br />AUTOMOSILELIA&Lltt <br />1 <br />ANY AUTO <br />I� <br />smnenl <br />$ <br />BODILY INJURY (Per person) <br />$ <br />ALL O SCHEDULED <br />AUTOS NQNOVVNED <br />BODILY INJURY (Per eaciden0 <br />_ <br />$ <br />HIRED 0.U'rOS AUTOS <br />PROPERTY DAMAG <br />Per accident <br />$ <br />$ <br />A X UMBRELLA UAD X OCCUR <br />Y <br />Y <br />EXCESS LM CLAMS-MADE <br />C[ACLAMS-MADE <br />6610512016 <br />06/1512017 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DEB X RETENTIONS 11101 <br />AGGREGATE <br />5 2,000,000 <br />_ <br />T <br />B WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />YPROPRIETORJPARTNEREXECUTIVE <br />92- CP-A530.4 <br />06/05!2016 <br />06/05/2017 <br />V✓C TA U- 0111- <br />0 1 X <br />1,000,000 <br />Y <br />EL EACH ACCIDEW <br />$ 1,000,000 <br />�YIN� <br />OFFICE/MEMaER EXCLUDED? L_'J <br />NIA <br />{Mandatory In NH) <br />F.L. DISEASE - EA EMPLOYE <br />I <br />$ 1,000,000 <br />tlesrsideuntler <br />DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />1 F <br />A FIDELITY eOND <br />Y <br />Ey <br />'EL. <br />92 -WV- 60445 -F <br />t0f0312016 <br />70/03/2017 <br />SOND-AMOUNT <br />$ SCg000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEWCLES (Attach ACORD 101, Additional Remarks schedule, If mere ¢pace 1¢ required) <br />Location: 2nd Street Promenade, 200 E Alley, 100 E. Alley, East End Promenade, Plaza Calla Cuatro <br />City Of Santa Ana Its officers, agents, employees and volunteers are named as additional insured. <br />Additional Insured endorsement issued for certificate holder with Wavier of Subrogat)on <br />CERTIFICATE HOLDER CANCELLATION <br />CITY OF SANTA ANA <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />20 CIVIC CENTER PLAZA SANT ANA, CA 92702 <br />NOONICE LL E ED IN <br />iHCO EXANAE10 T <br />THEE OTHEYREOFV� <br />ATTENTION RISK MANAGEMENT <br />BRIZA MORALES <br />AUTIIORI£EO REPRESENTATIVE�� <br />A --- _. <br />—ryea - avru ZuKu UEI!XrLurc I W(N. All rights reserved. <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 1001486 132849.7 03 -01 -2012 <br />