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A� b® CERTIFICATE OF LIABILITY INSURANCE <br />°ivi6M s <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: N the certWcate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the <br />terms and conditions of the policy, certain pollc)es may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(a). <br />Pf00110E1 Sanah Devereaux-Barnentos, Agent <br />1202 W 1St St <br />Arleftm Santa Ana, CA 92703 <br />CONTN T <br />NAM : IAH DEVEREAUX <br />PHONE 280 FAX <br />EA000Re : sanah.devereaum.181statefarm.com <br />INSUREgS] AFFORDINGCOVERASE <br />NNC , <br />INSURER A: Slate Fenn Fire and Casualty <br />INSURED CAZALES, ANAHI <br />DBA: BRIGHT FUTURE LEARNING CENTER <br />2320 N GRAND AVE <br />SANTA ANA, CA 92705 <br />INSURER e: <br />INSUREac: <br />INSURER D <br />INWR <br />! <br />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 />am <br />ME OF INSURANCE <br />L9U -, P NUMBER <br />PO EFF <br />POLICY EXPAM <br />namotIrrinryl <br />Lam <br />A <br />I oENEML tABe.IrY <br />X COMMERCIAL GENERAL LIABILITY <br />CWMS-MADE ❑X OCCUR <br />Y <br />11 <br />92-0IU/977i <br />03104W2 <br />0310112020 <br />EACH OCCURRENCE <br />5 1,000,000 <br />WISES (Fat <br />5 3W.000 <br />MEDEXa(Arone ) <br />s 5,000 <br />PERSONALSADV WJtRV <br />5 1,000,000 <br />GENERAL AGGREGATE <br />t 2,000,000 <br />DIDIL AGGREGATE MIT APPLIES PER <br />POLICY 7, WT Loc <br />PRODUCTS-COMPI(WAGG <br />s 2,000.000 <br />Business Properly <br />s S,DOU <br />AYTOYOeII! <br />LAearry <br />ANY AUTO <br />GAINEAUTSCHEDULE <br />OS D AUTOSO <br />HIREIOWNED <br />DAUFOG AUTOS <br />I <br />I a LE OMIT <br />5 <br />aOO1LYINJURY(Perptnon) <br />5 <br />BODILY INJURY(FW a.uCaX) <br />S <br />5 <br />f <br />UMBRELU LMa <br />EXCESS UAB <br />OCCUR <br />CLA)M"ADE <br />—JHS <br />EACH OCCURRENCE <br />s <br />AGGREGATE <br />s <br />DIED I I RFTEATIONS <br />WORKERS CDMPENSATIOM <br />ANDEMPLOYERS'UAINUTV <br />ANY PROPRIETOR/PARTHOUEXECUTVE Yln <br />OFRCEAAEIABBR EXCUJOED+ <br />(Mr„ eamry In NN) <br />M YW, aesrntR �n0ar <br />MIA <br />YID STATU- Ono <br />EL. EACH ACCIDENT i5 <br />EL DISEASE - EA EMPL <br />5 <br />E.L. DISFASE- POLICY 01dr s <br />DESCRIPTION of OPERATIONS I LOCATIONS'VEHICLES IAtesh ACORD "I. AMiSerul RNnIft iih�lw N mom*,n, M n,ui l <br />RE: Recreation Class Instructor <br />The Certificate holder is added as an additional insured, but only for liability caused, in whole or in pan. by the acts a omissions of the mired insured. <br />City will be mailed 30 days miters notice of policy cancellation and the references "Endeavor To' failure to mail such notice shall Impose no Obligation or liability <br />of any kind upon the Company, its agents or representatives" shall be removed or Crossed out. <br />CITY OF SANTA ANA <br />RISK MANAGEMENT DIVISION 19 20 <br />20 CIVIC CENTER PLAZA SANTA AN <br />SAMA HA M. U1 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />— 0-1988-2010 ACORD CORP All rights reserved. <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of A 001486 132849.8 01-23-2013 <br />