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STRADIS-01 RHONDAC
<br />.A4c"*v ' CERTIFICATE OF LIABILITY INSURANCE
<br />DAT
<br />Ziz12o1s
<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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder In lieu of such endorsement(s).
<br />PRODUCER License '# 0252636
<br />Gallant Risk &Insurance Services, Inc.
<br />4160 Temescal Canyon Rd., #402
<br />Corona, CA 92883
<br />CONTACT
<br />"----
<br />__ _
<br />PHONE - - FAx
<br />.JA&,A%XX0J951) 368-0700�aX Hm: (951) 368.0707
<br />_
<br />EMAIL
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAICA
<br />INSURER A: United Fire _&Cas_ualt Cy ompany13021___
<br />X
<br />INSURED
<br />INSURER IS: In su rance Compel riOfthe West
<br />27847
<br />Straub Distributing Co. LTD
<br />INSURER C
<br />$ 300,000
<br />INSURER _
<br />MED EXP (Any one parson)
<br />4633 La Palma Ave.
<br />Anaheim, CA 92807
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: REVISION NIIMRER:
<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 />IN A.._..._.._.....__.._... __.._.__._._.._._.._._____ D 9U .----_.__.__— dLTMFF- Pbu Y
<br />LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MM/DDN"Y LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIM&MADE EX] OCCUR
<br />X
<br />60472392
<br />02/0112016
<br />02101/2017
<br />pFTv a Ea occurrence) _
<br />$ 300,000
<br />MED EXP (Any one parson)
<br />$ 6000
<br />PERSONAL & ADV _INJURY
<br />_
<br />$ 1,000,000
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />O.
<br />POLICY X1- JE I LOC
<br />PRODUC'r$_COMPIOPAGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />_ _
<br />AUTOMOBILE
<br />_
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />-La son t
<br />S 1,000,000
<br />A
<br />X
<br />ANY AUTOX
<br />60472392
<br />02)0112016
<br />02/01/2017
<br />BODILY INJURY (Per person)
<br />$
<br />_
<br />ALL OWNED _SCHEDULED
<br />AUTOS AUTOS
<br />litl
<br />BODILY INJURY (Per accident)
<br />)
<br />$
<br />HIRED AUTOS NON -OWNED
<br />AUTOS
<br />PROPCRTYD MAGE
<br />fPer accitlenU _
<br />8
<br />X
<br />UMBRELLA UAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />AGGREOATE
<br />_
<br />$ 10,000,000
<br />A
<br />DAR
<br />60472392
<br />0210112016
<br />02/01/2017
<br />JEXCESS
<br />--,_L _CLAIM_.M_ADE
<br />DED X RETENTION$ 0
<br />����-$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory lnNH)
<br />If yao, dosarib0 under
<br />DESCRIPTION OF OPERATIONS below _
<br />NIA
<br />WSD502056604
<br />0210112016
<br />02/01/2017
<br />X _
<br />P _ OT ,F9jr _
<br />_ STATUTE „_____a�____
<br />E.L. EACH ACCIDENT
<br />—----------.--
<br />E. L. DISEASE - EA EMPLOYE
<br />$ 1,000,0_0_0
<br />$ 1,000,000
<br />E. L. DISEASE,POLICYLIMIT
<br />$ 11000,00
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace is required)
<br />RE: Anhouser Busch riestae`8040
<br />The City of Santa Ana, Its officers, employees, agents and representatives are listed as additional insured In regards to general liability and auto liability per
<br />the attached policy farms. Coverage Is primary and non-contributory par the attached policy forms.
<br />30 day notice of cancellation.
<br />• 1 I
<br />City of Santa Ana, Parks, Recreation & Community Services
<br />Agency -M23
<br />Attn: Silvia Cuevas
<br />20 Civic Center Plaza
<br />PO Box 1988
<br />Santa Ana, CA 92702
<br />SHOULD ANY OF THE ABOVE DE:
<br />THE EXPIRATION DATE THEI
<br />ACCORDANCE WITH THE POLICY
<br />AUTHORIZED REPRESENTATIVE
<br />�Jf0� aki-1�aial
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />WILL BE DELIVERED IN
<br />All riahla ra.arvad
<br />
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