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• lhtl/28/2005 11:22 7142589029 ALL SIGNS AMERICA PAGE 02 <br />A-20D3 -1AA <br />A-?, 63 - I44-0 t <br />STEVENSTRY IPOINTNCWISCONSINE A L COMPANY P}.2UD3' 1�11��QZ <br />fA PARTICIPATING MUTUAL COMPANY) <br />A MEMBER OF THE SENTRY FAMILY OF INSURANCE COMPANIES <br />CERTIFICATE OF INSURANCE ACCOUNT NUMBER 49-39070 <br />This certificate is issued as a matter of information only and confers no <br />rights upon the certificate holder, This certlficat• doe" not amend, extend <br />ur alter the covera➢e afforded by the policies below. <br />Name and Address of Nome and Address <br />Certificate holder of the Insured <br />THE [JTY OF SANTA ANA R i A EN-TERPRISES INC DNA <br />ITS QVFIC'ERS, EMPLOYEES. ALL SIGNS AMERICA <br />AGENTS, VOLUNTEERS 6 154al REDHILL AVE STE A&D <br />RESPRESENTATIVES TUSTIN, CA 9ZTB0 <br />2 CIVIC CENTER PLZ <br />SANTA ANA, CA 92701 <br />This certificate is issued on 09-23-2005 and is effectivo until 09-2b-2006. <br />It certifies that policies of insurance listed below have been issued to <br />the insurad named above, hotwlthatandlnp any raqulrement, term or <br />conditi7n of my contract or other document with respect to which this <br />certificate may be issued or may pertain, the Insurance afforded by the <br />Policies described herein is subject to all the terms, exclusions, and <br />conditions of such policies. Limits shown may have been reduced by Paid <br />claims. <br />Coveraea Provided <br />Policy Number <br />All Limits in Thousands <br />Businessawners Liability <br />49-39070-91 <br />Each Occurrence <br />4 <br />Sao <br />Includes: Bodily Injury <br />M■dicml Expense <br />Domepe to Premises <br />4 <br />a <br />l0 <br />250 <br />Property Damage <br />General Agprapate <br />4 <br />1.500 <br />Personal Injury <br />Products pprepate <br />4 <br />1,500 <br />Advartisinp In�ury <br />Hired and Non- <br />caned <br />Workers' Compensation and <br />49-39070-02 <br />Statutory <br />Employer's Liability <br />Each Accident <br />4 <br />500 <br />Each Disease/Emolaymm <br />a <br />500 <br />Each Disease/Policy <br />S <br />500 <br />Umbrella Liability <br />49-39070-03 <br />Each Occurrence <br />4 <br />1.000 <br />Dues Not Include: <br />General Aggravate <br />4 <br />1,000 <br />-Pera/Adv Injury <br />Products Agorsoate <br />0 <br />1,000 <br />APPROVED AN To FORM <br />^2p <br />aura Stitt S dy <br />n.,sistant City ttorney <br />00-CI035 ISFA) <br />ALL 49-39070 31-040416 ,•.,w. <br />10-2a-ZDDS <br />PAGE I <br />(000'7) <br />