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ACORD.— TCERTIFICATE OF LIABILITY INSURANCE 0212812007 <br />PRODUCER Ph": (800) 3958075 I= (858) 5190922 THIS CERTIFICATE 15 ISSUED AS A MATTER OF <br />FITNESS AND WELLNESS INSURANCE AGENCY INFORMATION <br />380 STEVENS AVENUE, SUITE 206 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />SOLANA BEACH CA 92075 <br />INSURERS AFFORDING COVERAGE I NAIC # <br />rKAR-,ATE ...A -003 -Lf ?j <br />ARTIN TORRES N _' , O 0,3 , D `{ —C� <br />RANCHERO WAY aD�j /�% EN GROVE CA 92843 <br />INSURER FC <br />INSURER e: <br />A <br />GENERAL AGGREGATE $ 3,000,900 <br />INSURER C <br />X POLICY PRO- m <br />INSURER E: <br />LIABILITY <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICYPERIOD INDICATED. NOTWITHSTANDING <br />ANY REOUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES AGGREGATELMITS SHOWN MAY HAVE BEEN REDUCED By PAID CLAIMS. <br />valn'EVwAnox LIMITS <br />'�eDL TYPE OF 115URANCE POLICY NUMBER eaICY FF(fL1NE <br />LTR E 1,000,000 <br />GL-NEWLL WBBJTY 5763733 -M 01124107 01/24I0S EACH OCCURRENCE <br />I»MmeTOIENIEU E 100,000 <br />X COMMERCIAL GENERAL UABI PItBISES(E. <br />CLAIMS MAD OCCUR MED. EXP (A.iy ate Peleon) E 2,500 <br />PERSONAL 6 ADV INJURY $ 1,000,000 <br />A <br />GENERAL AGGREGATE $ 3,000,900 <br />GENT AGGREGATE OMIT APPLIES PEI PRODUCTS - COMP /OP AGG. $ 3,000,000 <br />X POLICY PRO- m <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />(Ea ecadMM <br />$ <br />BODILY INJURY <br />(Pw P�) <br />E <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON-OWNED AUTOS <br />BODILY INJURY <br />( ) <br />E <br />PROPERTY DAMAGE <br />E <br />GARAGE LIABILITY <br />AUTO ONLY -EA ACCIDENT <br />E <br />OTHER THAN EAACC <br />AUTO ONLY: AGO <br />E <br />ANY AUTO <br />/.� <br />IS <br />EACH OCCURRENCE <br />E <br />EXCESS 'U MBITELLA LIABILITY <br />OCCUR CLAIMS MADE <br />AGGREGATE <br />S <br />S <br />E <br />DEDUCTIBLE <br />RETENTIONS <br />S <br />WORKERS COMPENSATION AND <br />EMPLOYERS' UMBILITY <br />WCaTAl4 0T <br />iaiv lAllis <br />E.L.EACHACCIDENT <br />$ <br />E.L. DISEASE -EA EMPLOYEE <br />E <br />PROPRETORMA <br />Ex0.wEUt <br />•yr, ar>M �,/,r <br />ePE�111LlROYO01a Y.bx <br />E.L. DISEASE - POLICY LIMIT <br />S <br />OTHER: <br />DESCRIPTION OF OPERATIONS /LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br />The City of Santa Ana, Its officers, employees, agents, and representatives are added as an additional insured but only as respects the <br />operations of the named Insured except that liability resulting from the additional insureds sole negligence. <br />Additional Insured Endorsement is Effective: 02127107 <br />rAUrvl I ATInfd <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILLENDEAVORTO MAIL10 <br />DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT <br />The City Of Santa Ana, its officers, FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br />employees, agents and representatives. INSURER, ITS AGENTS OR REPRESENTATIVES. <br />P.O. Box 1988 M -23 AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92702 <br />Attention: Jeffrey E . Frick, CEO <br />ACORD 25 (2001108) Certificate # 53683 © ACORD CORPORATION 1988 <br />