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A4cil CERTIFICATE OF LIABILITY INSURANCE <br />DATE <br />09/23/2014 <br />09/23I /2014 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION <br />Dennis Rosette Agency, Inc. <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />2503 Eastbluff Dr Ste. 201 <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Newport Beach, Ca 92660 <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />LTR <br />, <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />CESAR VARGAS PEA MENTE INC <br />INSURERA: State Farm General Insurance Company 25151 <br />LIMITS <br />6543 E VIA FRESCO <br />INSURER B. <br />92- CP-W817 -7 <br />INSURER <br />05/16/2015 <br />ANAHEIM CA 92807 -4914 <br />INSURER D' <br />TiTgTGETURTI <br />PREMISES Ea occurrence <br />$ <br />INSURER E'. <br />HOO OI + )6w <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER (DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY Be ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />ADEL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />POLICYEFFECTIVE <br />POLICY EXPIRATION <br />LTR <br />INSRD <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE MMIODIW <br />DATE MMIDDIYY) <br />LIMITS <br />GENERAL <br />LIABILITY <br />92- CP-W817 -7 <br />05/16/2014 <br />05/16/2015 <br />EACHOCCURRENCE <br />$ 1,000,000 <br />TiTgTGETURTI <br />PREMISES Ea occurrence <br />$ <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE OCCUR <br />MED EXP An ana p ersan <br />$ 5, 000 <br />X <br />PERSONAL &ADV INJURY <br />$ 2,000,000 <br />THEFT <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GEN'LAGGREGATEUMFAPPLIES PER <br />PRODUCTS- COMP/OP ASS <br />$ <br />PRO - <br />POLICY JECT LOC <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />BODILY INJURY <br />(Per person) <br />$ <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(Per accident) <br />$ <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />GARAGE LIABILITY <br />AUTO ONLY -EA ACCIDENT <br />$ <br />OTHERTHAN EA ACC <br />$ <br />ANY AUTO <br />AUTO ONLY: <br />AGO <br />$ <br />E %CESSIUMBRELLA <br />LIABILITY <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />OCCUR [::] CLAIMS MADE <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABILITY <br />WC STATU7 OTH- <br />Y' TORYLIMITS ER <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETOWPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />If yes, describe under <br />E.L. DISEASEEA EMPLOYEE <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />SPECIAL IAL PROVISIOISIO NS below <br />OTHER <br />BUSS PROP. COVERAGE <br />92- CP- W817 -7 <br />05/16/2014 <br />05/16/2015 <br />D UC. $ <br />$10,800 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES EXCLUSIONS ADDED BY ENDORSEMENT I SPECIII R ION <br />Jose Sandoval <br />Sen' r Assistant CitY Attorney <br />CERTIFICATE HOLDER CANCELLATION <br />AGURD 25 IZUUIIUU) I he registration notices Indicate ownership of the marks by their respective owners VACORD CORPORATION 1988, 2007 <br />132849 03 -13 -2007 All rights reserved <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br />Dennis A. Rosene <br />AGURD 25 IZUUIIUU) I he registration notices Indicate ownership of the marks by their respective owners VACORD CORPORATION 1988, 2007 <br />132849 03 -13 -2007 All rights reserved <br />