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<br />MAR 05 2004 lO:27AM HP LASERJET 3200 <br />SÈNT BY,' VAN DUZE" <br />" INSUMNCE¡ 3106960830; FEB-3-04 4:10~U; PAGE 2/13 <br /> <br />f~~tftl~.:~i\_Ç'~'Ç;~ ;r:~~L'.":~~ ~1;~;:~D'J~:~~f~i;~:~'~~~~C~ . <br /> <br />; CGNFIAI 110 ..8i1T& U- 1M! C!ll'TlflCATE HOLDI'" THIS CIIITIfIC,t'TI <br />f DOIS NOT All_. emllD 011 ALTER THI! COVEIWIf _OIID!D IY 1ME <br />" .~S IELOW. <br />COMPANIES AFFORDING COVERAGE <br /> <br />p.2 <br /> <br />Dick Van Duzer k A.IOC., Xnc. <br />P. O. Box 49894 <br />Lol Ange1.I, CA 90049-0894 <br />(310) 476-6561 VaK 476-2619 <br /> <br />:' A HARTrORD INStllUlHCB <br /> <br />*lUIIfD <br /> <br />=" 8 <br /> <br />HYGIBNE TBCHNOLOGIBB INTBR. <br />3625 DBL AMO BLVD. #180 <br />'1'ORRANCII:, CA 90503 II ~ ;;'00;;;" ~ I:J..;), <br /> <br />-4 - ;>¡JO3- Og <br /> <br /> <br />:"..-.. ."." ", ",:~",~;!Wj;".;¡¡~;¡¡;¡;;:;;¡,,;, ,.', "¡¡!fL.,,,.';: ,~!;!ffi,~:¡;:¡:;;:;~"::bR~Jo;l~I:'f.Er£~H!»_!i#;¡";d¡i;¡';¡~¡~i,,,,iè"p":,':fir,:,"; <br />'HI~'~ TO CEIm'" _T THE POUCI'. Of '.IU""IO< umD BELOI'/ HAVE NlN IlIIJEO to THE INIU.ED NIIMED AIIOIIf'OII TH' PnUCY ""100 <br />IfOICA'ED. NO1WfTNST"""NG AIIV RECUIÆMfNT, IF.... OR CONDITION Of ,",Y CClNtllloCT 011 OtHal DOCUMENT WITH ftE$PECT to WHICIi THII <br />CERTIFICAtE MAY BE ISSUED o~ ~AY I'ElltA"'. TIt! ;NSUAAHC( AfJ'CRC1!O øy THE I'QUCIBI DESQIIIBW WEAEIN ;5 5Ufl1ECT TO All tHE t...... <br />"CUISIONS AND CÇN,~S...,.SUCH PO!:!ÇES,..!-""" Sl<0WN ,"':' W~"..~"N ~,~..~ P~.ClAiMS. <br />: ............... 'JOUIT_- <br />, .... {-"""I: ....(MIIotHWfI <br /> <br /> <br />'""" .. -- <br /> <br />...... ..... <br /> <br />.... <br /> <br />A : -.. ........ <br />, 'X"CO'.""""'_Ll¡a1t'/ <br />, ". ........... ,. [. "(,,... <br />.. 'Ù.... . CON _""'0 'mar, <br /> <br />71 IBA LGII74 <br /> <br />;,~..~iE I 4,OOÓ,~øo <br />"~"" I IXCLUD <br />:09/15/03 09/15/04",.......,,',"","""" 2,OÖÓ~ÓOO <br />..",occo-,2; ööo;öci'ö <br />-.......",,-.., I 300,000 <br />"'¡';;;;....:¡..;;'M.;;;iï '10,00 <br />.. eóNo.,. IOIOI.E <br />i"" . 2,000,000 <br />¡09/15/03 ,09/15/0':._"""'" <br />,"" """ <br />'1IOOIl,- <br />ir.....- <br /> <br />""'OUt,. ""01 <br />."'. <IItCI <br />: x NQN,'-D """" <br />-.. ''''''IN <br /> <br /> <br />71 81A LG5174 <br /> <br />, ""'P,"N IIOMtOE <br /> <br />:......,- <br />""....-",..... <br />, OMR '"'" .-.... """ <br />WOOll...._- <br /> <br />... <br />_I' IM8ILm <br /> <br />i<~~/7j <br /> <br />, ....."""""-'" <br />;~Ä'¡" <br />"",..,"",.".-,., <br /> <br />" ':ri,Ïlìiar. Liiiiis ': ,.""",':'",., <br />: !.<cM ACe""'" I <br />,....,..,......,.. ,.., <br />LOSEAS"""IC'I.."'" I <br />, ,. ...... . ..... OWL"'" <br /> <br />" <br />:, <br /> <br />....... <br /> <br />........;,¡¡....'..¡¡¡'nöicM';;"~ - ,. <br />THB CITY OF BANTA ANA, ITS OJ'J'ICJ:RB, BHPLOYElJS, MBNTS AND <br />~:P~~~~~X~~S ARB NAMBD AS ADDXTIONAL IHStJRJ:D NON OWNBD AU'l'OMOBILB <br /> <br />"'-'~ ~..'.- "MA,'f~'P;~¡"'j <br /> <br />, ", mil";!;'+ ';¡¡~I~,iffi""~~mt¡¡m-.!~p~¡¡*",):':."',::"j';;;\i;;,,;::":~,,, <br /> <br />CITY or BANTA AHA <br />ATTN: RISK NANAGZMENT D1VISION <br />PO BOX 1986 M-28 <br />SANTA ANA CA 92702 <br /> <br />SHOOU) - OF THE '90\1E IlESCNKO POUCtU U¡ CANetl"'" SSFORE THE <br />""'"""ON CATE """EOF. THE ISSUING COM'AN' WIL' ~ <br />MAIL -.11 OAYS WflITTeN IKITICE TO THE CfIItIRCATE HOLOER .""0 TO THE <br />LEFT, .., I""UAE fa WI' .."'" ,a1t.. ..- ,M~"Ù O ,...,.&'I"", "" <br /> <br /> <br />$, <br /> <br />'fii~:"";"^"""," <br /> <br />;~,: <br /> <br />~ <br />