SANTA FE BUILDING MAINTENANCE (2) - 2017

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Policy Number: Date Entered: 1/8/2009 ACORD CERTIFICATE OF LIABILITY INSURANCEDATE 12/ 1/2017) 1ID 2/ o17 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER VICTORIA INSURANCE AGENCY Chris D. Victoria 1740 West Estella Ave #H CONTACT CHRIS VICTORIA NAME: PHONE (714)744-4500 FAX (714)744-2500 AlC No E#: AIC, No: AIL ADDRESS: victoriainsurance345@gmail.com INSURER($) AFFORDING COVERAGE NAICN Orange, CA, 92867 INSURER A: TRUCK INSURANCE EXCHANGE 21709 INSURED SANTA BE BUILDING MAINTENANCE INSURERS: MID—CENTURY INSURANCE COMPANY 21687 GUADALUPE MEDINA - A—ZDI:r1,—Z11 ` "'1O INSURER C: 15644 PALOMINO DRIVE CHINO HILLS, CA 91709-5510 INSURER D: INSURER E: INSURER F : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD J INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDDL SUBR POLICY NUMBER 60366-65-69 MMmPOLIDYIYYYY 03/29/2017 MMIODIYYYY 03/29/2018 LIMITS EACH OCCURRENCE $1,000,000 A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Ix OCCUR X DAMAGET RENTED PREMISES Ea occurrence $ 75,000 MEG UP (My one person) $ 5,000 PERSONAL a AOV INJURY $1,000,000 LIMITAPPLIES PER: POLICY ❑ JET � LOC GENERAL AGGREGATE $2,000,000 GEN'LAGGREGATE PRODUCTS - COMP/OP AGG $1,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $1,000,000 ANY AUTO BODILY INJURY (Per person) $ B OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 60486-94-07 01/01/2018 01/01/2019 BODILY INJURY Pera¢idmt ( ) $ PaccB Y DAMAGE Parer accdent $ A UMBRELLA LIAR OCCUR EACH OCCURRENCE 2,000,000 $S�MADE EXCESS LIAS CLAIM 60499-63-93 03/29/2017 03/29/2018 AGGREGATE $ DED X RETENTION $ 10, 000 S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY OFFICEWMEMBER EXCLUDED?ECUTIVE ❑ N/A A0931-60-44 12/15/2017 12/15/2018 PER OTH- STATUTE ER E.L. EACH ACCIDENT $2,000,000 E.L. DISEASE -EA EMPLOYEE $2,000,000 (Mandatory In NM) U yes, deecdbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $2,000,000 A EMPLOYEE DISHONESTY 60366-65-69 3/29/2017 3/29/2018 $1001000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarm Sohedule, may be attached If mom apace la mqui ADDITIONAL INSURED ENDORSEMENT ATTACHED /j6 CITY OF SANTA ANA POL 60 CIVIC CENTER PLAZA SANTA ANA, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE % C � ;HRIS VICTORIA Yn "z e �a a-+ ©1988-2015 ACORD CORPORATION All rmhtc mmrvnH ACORD.26 (2016103) The ACORD name and logo are registered marks of ACORD Produced usino Forms Boss Plus software. www.FormsBoss.com: Imoressive Publishina 800-208-1977