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CERTIFICATE OF LIABILITY INSURANCE <br />DATE <br />06/20D2016) <br />n6 /2o /zole <br />PRODUCER <br />STATE FARM INSURANCE - Jeff Biddle, AGENT <br />503 S GLASSELL STREET <br />ORANGE, CA 92866 <br />X <br />THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />Sandwood Ent Inc. <br />DBA Orange County Sandbagger <br />2424 N Batavia Street <br />Orange, Ca 92865 <br />INSURER& State Farm Mutual Auto Insurance Company 25178 <br />LTR <br />INSURER B: <br />TYPE OF INSURANCE <br />INSURERC: <br />DATE MMIDD <br />INSURER D: <br />LIMITS <br />INSURER E: <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 />ADVL <br />DATETHERBOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br />employees and Volunteers. <br />POLIO EFFECTIVE <br />POLICY EXPIRATION <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND U PON TH E INSURER, ITS AGENTS OR <br />LTR <br />IMD <br />TYPE OF INSURANCE <br />POLICYNUMBER <br />DATE MMIDD <br />DATE (MMI <br />LIMITS <br />GENERAL <br />LIABILITY <br />EACH OCCURRENCE <br />$ <br />PREMISES Eao maIw <br />$ <br />COMMERCIAL GENERAL LIABILITY <br />MED EXP Aw one arson <br />$ <br />CLAIMS MADE I-IOCCUR <br />PERSONAL S ADV INJURY <br />S <br />GENERAL AGGREGATE <br />S <br />GEJLAGGREiATEUMTAIPUESPER: <br />PROOUCTS•COMP,OPAGG <br />S <br />P- <br />'Y POLICY JECRO T <br />A <br />x <br />gUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />132 9265- D28 -75K <br />04 -28 -16 <br />04 -28 -17 <br />COMBINED SINGLE LIMIT <br />(Ea ac dent) <br />$ 1,000,000 <br />X <br />ALLOWNEDAUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(Per j9Y500) <br />BODILY INJURY <br />(Perac6dont) <br />$ <br />X <br />X <br />HIREDAUTOS <br />NON- OWNEDAUTOS <br />PROPERTY DAMAGE <br />(Per amodent) <br />$ <br />GARAGE LIASRITY <br />AUTO ONLY - EAACCIDENT <br />$ <br />OTHER THAN EAACC <br />S <br />ANYAUTO <br />AUTO ONLY_ <br />AGO <br />E <br />EXOESSIOMBRELLA <br />LIABILITY <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />S <br />OCCUR F7CI-AIMS MADE <br />E <br />$ <br />DEDUCTIBLE <br />I <br />RETENTION b <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABILITY <br />I WC STATU- OTH- <br />TCRY LIMITS ER <br />E.L. EACH ACCIDENT <br />$ <br />ANY PROPRIETORAPRTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />Nyas,de9PRO PROVISIONS <br />SPECIAL PROVISIONS below <br />EL DISEASE - EAEMPLOYEE <br />E <br />EL DISEASE- PQLICY LIMIT Is <br />OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVIS S <br />Job description: All Operations <br />CERTIFICATE HOLDER CANCELLATION <br />City Of Santa And <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />its elected and appointed officials, offocers, <br />DATETHERBOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br />employees and Volunteers. <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />Engineering Department <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND U PON TH E INSURER, ITS AGENTS OR <br />20 Civic Center Plaza <br />REPRESENTATIVES. <br />Santa Ana, CA 92701 <br />AUTOO WED REPRESENTATIVE <br />Jeff Biddle, AGENT <br />AQQKU 25 (2001105) 1 e reg is ra Ion notices ind 7ca7eqmersFI IF marks Uy MET respec IVe OWnerS c <br />1 52849 OS-13-2007 All rights reserved <br />