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CERTIFICATE OF INSURANCE <br /> <br />PRODUCER <br /> <br /> Markel Insurance Company <br /> P.O. Box 3870 <br /> Glen Allen, VA 23058-3870 <br /> <br />CODE SUB-CODE <br /> <br />INSURED <br /> <br />Boys & Girls Club of Santa Aha, <br /> <br />A California Corporation <br /> <br />950 W Highland <br />Santa Aha, CA 92703 <br /> <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br />NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMENE <br />EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> <br />COVERAGES <br /> <br /> COMPANIES AFFORDING COVERAGE <br /> <br />COMPANY <br /> A MARKEL INSURANCE COMPANY <br />LETTER <br /> <br />COMPANY <br /> B <br />LETTER <br /> <br />COMPANY <br /> C <br />LETTER <br /> <br />COMPANY <br /> D <br />LETTER <br />COMPANY E ~"'~'-. <br /> <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED <br />POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT .......... <br />WITH RESPECT TO WHICH ~rH S CERT F CATE MAY BE SSUED OR MAY PERTAIN, <br />HEREIN rs SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH PO <br /> <br />THE INSURED NAMED ABOVE FOR THE <br /> CONTRACT OR OTHER DOCUMENT <br /> ~RDED BY THE POLICIES DESCRIBED <br /> iTS SHOWN MAY HAVE EIEEN REDUCED BY <br /> <br /> TYPE OF INSURANCE <br /> <br />GENERAL LIABILITY <br /> <br /> COMMERCIAL GENERAL LIAt~ILITY <br /> CLAIMS MADE ~-~ OCCUR. <br /> OWNERS & CONTRACTOR'S PROT. <br /> <br />POLICY NUMBER <br /> <br /> LIMITS <br /> <br />GENERAL AGGREGATE 3,000~000 <br />PROGUCTS~COMP/OPS AGGREGATE 1,000, 000 <br />PERSONAL & ADVERTISING INJURY 1,000~000 <br />EACH OCCURRENCE 1,000,000 <br />EIRE DAMAGE (Any one firel 100,000 <br />MEDICAL EXPENSE (Any One person) 5~000 <br /> <br />AUTOMOBILE LIABILITY <br /> ANY AUTO <br /> <br /> ALL OWNED AUTOS <br /> SCHEDULED AUTOS <br /> HIRED AUTOS <br /> NON-OWNED AUTOS <br /> GARAGE LIABILITY <br /> <br /> 8502~00~3-~'~ <br /> <br />OTHER THAN UMBRELLA FORM <br /> <br />OTHER <br /> <br />Inland Marine <br />Property <br /> <br />12-20-2003 <br /> <br /> 8502CY073003-5 12-20-2002 12-20-2003 <br /> <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS <br /> <br /> Certificate holder is included as additional insured for operations conducted by the named insured. <br /> <br />CERTIFICATE HOLDER CANCELLATION <br /> <br />COMBINED SINGLE <br />LIMIT <br /> <br />BODILY INJURY <br />IPerPerson) <br /> <br />BODILY INJURY <br />(Peraccident) <br /> <br />PROPERTY DAMAGE <br /> <br />EACH OCCURRENCE <br />AGGREGATE <br /> <br /> STATUTORY LIMITS <br />EACH ACCIDENT <br />DISEASE - POLICY LIMIT <br />DISEASE - EACH EMPLOYEE <br /> <br /> Clerk of tt3e City Counci) *City of Santa Aha <br /> 20 Civic Center Plaza <br /> <br /> PO Box 1988 <br /> <br /> Attn: Maria Yanez <br /> <br /> Santa Aha, CA 92702 <br /> <br />ACORD 25-S(7/90) <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO <br />MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO <br />THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION <br />OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR <br />REPRESENTATIVES. <br /> <br /> Bruce A. Kay CPO <br /> ( D CORPORATION 1990 <br /> <br /> <br />