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Policy Number:
<br />Date Entered: 1/8/2009
<br />All d CERTIFICATE OF LIABILITY INSURANCE
<br />DA3/TE 114/20171
<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 have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement, A statement on
<br />this certificate does not confer Nghts to the certificate holder In lieu of such endorsements ,
<br />PRODUCER
<br />CONTA T`.HRIS VICTORIA
<br />NAMa:
<br />VICTORIA INSURANCE AGENCY
<br />_,,,,_,--.-d--.- . .
<br />PncNe (714)7,94-9500 �F —Na,714)794-2500
<br />Chris D. Victoria
<br />EMAIL ._._.,_.,...", ._....., _,_,,.......
<br />victoriainsurance345@gmail. com
<br />1740 West Katella Ave #H
<br />ADORES
<br />_._,_, INSURER(SI AFFORDING COVERAGE
<br />NAIC#
<br />Orange, CA, 92867
<br />NSURERA:TRUCK INSURANCE EXCHANGE
<br />21709
<br />«.�
<br />LDING MAI INSURED SANTA FE BUINTENANCE t�
<br />INSURER MID-CENTURY INSURANCE U6PANY-
<br />zx6e�
<br />INSURER c:
<br />GUADALUPE MEDINA
<br />INSURER D:
<br />15644 PALOMINO DRIVE
<br />CHINO HILLS, CA 91709-5510
<br />INSURERS
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<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 />LTR ............... _....... ... .........
<br />TYPE OF INSURANCE ADDLE eft P L YEFF PO GYEXP
<br />AID POLICY NUMBER MMIOOIYYYYMMIDDNYYYl LIMITS
<br />A
<br />COMMERCIALaENERAL LIABILITY
<br />CLAIMS -MADE ®OCCUR
<br />X
<br />60366-65-69
<br />03/29/2017
<br />03/29/2013
<br />EACH OCCURRENCE
<br />S1,000,000
<br />MET6?fENTFo`-
<br />DREMIBEB lEa ocwrrenceL__
<br />S 75, 000
<br />MED EXP An one ersan
<br />$ 5,000
<br />PERSONAL&AOV INJURY
<br />$1,000,000
<br />GENERAL AGGREGATE
<br />$210001000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER ',T
<br />POLICY❑PEC F—]LOC
<br />PRODUCTS-COMP/OP AGO
<br />$ 1,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE LIABILITY
<br />Ea aa,deDtISIN LE LIMIT
<br />$ 1,000,000
<br />BODILY INJURY (Per Person)_
<br />$
<br />ANYAUTO
<br />OWNED SCHCULED
<br />AUTOS ONLY AUTOS
<br />60486-94-07
<br />g1/01/2017
<br />1/01/2018
<br />DOILY INJURY (Per accident)
<br />$
<br />B
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTY DAMAGE
<br />IPeracGentd
<br />"-"' '-
<br />$
<br />$
<br />A
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE
<br />$2,000,000
<br />AGGREGATE__
<br />S
<br />EXCESS LII
<br />CLAIMS -MADE
<br />60499-63-93
<br />03/29/2017
<br />03/29/2018
<br />CEO
<br />RETENTION S 10, 000
<br />$
<br />H
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOWPARTNEWEXECUTIVE YIN
<br />OFFICEMMEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />NIA
<br />A0931-60-49
<br />12/15/2016
<br />12/15/2017
<br />BTATU E ER
<br />E.LLEACH ACCIDENT
<br />_
<br />$2,000, 000
<br />E.L. DISEASE. PA EMPLOYEE
<br />$2,000,000
<br />1 yes, describe end.,
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE -POLICY LIMIT
<br />$2,000,000
<br />A
<br />EMPLOYEE DISHONESTY
<br />60366-65-69
<br />3/29/2017
<br />3/29/2018
<br />�
<br />$100,000
<br />DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES ACORD 101, Additional Remarks Schedule, maybe attuhedl/m.T.S,ae iarequlred)
<br />ADDITIONAL INSURED ENDORSEMENT ATTACHED
<br />CITY OF SANTA ANA POLICE DEPARTMENT
<br />60 CIVIC CENTER PLAZA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />SANTA ANA, CA 92701 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE ^ `
<br />vil
<br />3HRIS VICTORTA `/I 1 y--
<br />ACORD 25 (2016103)
<br />The ACORD name and logo are registered marks of ACORD
<br />Produced usina Forms Boss Plus software. www.FormsBoss,com, Imoressive Publishing 800-208-1977
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