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R � CERTIFICATE OF LIABILITY INSURANCE <br />D03iosn0a 4Yl <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 13ETWEEN THE ISSUING INSURER($), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THECERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the' policy(tes) must be endorsed. If SUBROGATION IS WAIVED, a__ t to <br />the terms and conditions of the policy, certain policies may requha an andomement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such andomamon s . <br />PRODUCER <br />STEVE DWIGHT <br />StateFarm 4625 E ANAHEIM ST <br />owl LONG BEACH, CIA 90504 <br />E. PO BOX <br />PN NE 562 -094.4494 FAX 5 <br />at.Ea11' IRrc, Nm; 62. 597.6680 <br />E'61A16. patty .ddessen.isbe@statefartn.com <br />INSURER ($) AFFORDING Do BE <br />NMC r <br />INSURRR 01ate Farm Mulusl Automobile Insurance Company <br />26778 <br />COMMERCIAL GENERAL, UABIUTY <br />D AIMS awD¢ Q OCCUR <br />INSURED INTERVAL HOUSE <br />PO sox 3356 <br />SEAL BEACH, CA 90740 <br />INSURER a: <br />INSURERC: <br />3 <br />INSURHR D: <br />DAMAGE TO RENTED <br />NBURER E: <br />S _ —^ <br />INSURER F: <br />...._ <br />INUIUATIZO, NQTVYITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY 8E 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 I4AW REFN RFIB ICPn Rv pmn n AsaA <br />NSR <br />TYPSOFINSURANCE <br />POLICY NUM$¢ <br />POLICY <br />NUCYE%P <br />.{JMRS <br />COMMERCIAL GENERAL, UABIUTY <br />D AIMS awD¢ Q OCCUR <br />EACH OCCURRENCE <br />3 <br />DAMAGE TO RENTED <br />s <br />S _ —^ <br />...._ <br />MED EXP (My oie Fempn) <br />- - -.- <br />PERSONAL &ADV INJURY <br />S <br />AOGREGAT¢ LIMIT APPLIES PER: <br />POLICY 0 JEC QLOC <br />GENERAL AGGREGATE <br />OWL <br />S y <br />PRODUCTS - COMP /OP AGG <br />_ <br />3 <br />I O ER <br />g <br />A <br />AUTOMOUILSUABIL1TY <br />X <br />x <br />x <br />X <br />ANY AUTO <br />AUTOS X SAO UL¢D <br />NoN -OWNED <br />HIRED AUTOS x AUTOS <br />X <br />076.7305-007 -76D <br />003.9985•F29.751 <br />032-4300. 021.761 <br />292.2671 -019.758 <br />03107/2018 <br />03,07!2016 <br />Fo I L T <br />BODILY INJURY (Per parson) <br />g 1,004000 <br />g <br />g - -- <br />BODILY lNJURY(Par ga^faN) <br />a R 1 AMA E <br />-- <br />g <br />-- - --- -- <br />a <br />UMBRELLA LIAO <br />EXCESS WAS <br />OCCUR <br />ClA1MSMADE <br />EACH OCCURRENCE <br />g <br />AGGREGATE <br />t <br />ago RETENTION $ <br />YAOMMIS COMPINISATBJN <br />ANOEMPLOYBRSLIABILITY YIN <br />ANY PROPRIETORIPAATNEREYECUTIYE <br />OFFICERRAEMBER EXCLUDED? DNlA <br />I DATUM ER <br />g <br />E.L. EACH ACCIDENT <br />g <br />(Ny4wntnmryln NN) <br />OESCRIP'n NOOF OPERATIONS DefvW <br />E. L. OISME•EA EMPLOYEE <br />S <br />E.L DISEASE - POLICY LIMIT <br />S <br />794CPoPnON OF OPERATIONS I LOCATIONS I VENICLee(ACOR01Ci,AddnlanM aemarke Sahedelo. may be oeached N mom apace IsrequIred) zi) <br />A owp tCK <br />AttOYn Y SlStant <br />CITY OF SANTA ANA <br />ADMINSTRATIVE SERVICES DIVISION <br />ATTN: FRANK HERNANDEZ <br />20 CIVIC CENTER PLAZA, M -25 <br />SANTA ANA, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION j3AiE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WI THE POLICY PROVISIONS, <br />ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD 1001486 132840.9 02.04 -2014 <br />