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<br />14:02
<br />
<br />TDIA
<br />
<br />PAGE
<br />
<br />02/03
<br />
<br />, '
<br />
<br />949450~
<br />
<br />j AJ:;QRP.. CERTIFICATE OF LIABILITY INSUR NC~o~1~ D CA~~~~~~
<br />
<br /> p~ODI)CER THIS C ~RTlFlCATE IS ISSUED AS A MATTER OF INFORMATION
<br />I ONLY ¡.ND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />i ..,r~ Dootors Insurance Agen~ HOLDE R. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />. /- <.O:~~~'~1o:l Points Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />
<br />."':-'.é:',,, :Ülls CA 92653
<br />) ?~,1cne: 949-460-8730 FAX: 949-460-8733 INSURERS AFFORDING COVERAOE:
<br />
<br /> 'ïÑŠÜRB>-"-'" CO rect;.~I1:~'-~=~:d Ca~e.---.._-_.__.__._~t~t~:::, :~"'::~e F~:l'~ Mä~~~~:::Ï~~: c ., .,'~:-.'~--
<br />; ~i.cal corporat1.on INS"R~';-C..'---' .."--..,.-- ..-.-...--.-----
<br />iU:loberta Paz--~.,--- _n ".' "..-.------.----
<br />2 Q 4 0 S. San ta CJ:UZ INSURER D
<br />)"....."a..~eim CA 512805 -----, ..
<br />INSURER E
<br />
<br />t,.
<br />
<br />...-. .-----_.~,""
<br />
<br />.......-------.-.---.----.---"-..-..
<br />
<br />--"'-'--....,....-r.~_-.
<br />
<br />:. '-:',::~;i, ::;¡:s
<br />
<br />I -i-IF. POI-'CIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED to THE INSURED NAMF.D ABOVE FOR n E POLICY PERJOtIINOICATED. NOTWITHSTANr,JING
<br />! "lilY REaV~EMF.Nl TERM OR CONDITION OF ANy CONTRACT OR OTHER DOCUMENT WITH RESPECT TO' mlGH THIS CE;RTIFICA1lõ MAY !IE ISSUED OR
<br />I ,'MV PliRTAIN. THIO INSURANCE AFFOADED!!IY THE POLlC"S DESCRIBED HERËIN IS 9UIIJECT TO AI.I. THE fF.RMS. EXCLUSIONS AND CONÒIÎIONS OF SUCH
<br />! "OVCIES. AGGRr:GATE LIMITS SHOWN MAY HAVE. BEEN REDUCeO (1Y PAID CLAIMS.
<br />~T\'~-"'--""-"""-""'" ..... '''-ø., ,"_..._n._-o", . ... .
<br />. ""''''E OF 'NSU~ANCE POLICY NUMØER
<br />
<br />".-,""c'.,''''''1
<br />
<br />
<br />......-..----.-.-.-..--- -
<br />
<br />;-~ : CO'v""'Ë~CIAI. GeNE;RAl LIAI1IL1TY
<br />,. ) I CLAIMS MADe [~J OÇCUR
<br />I
<br />-..-..1 "-""."""""."" .
<br />
<br />131'1:01497314
<br />
<br />06/01/03
<br />
<br />06/01/04
<br />
<br />1..1~IT.e
<br />ËACH OCCURRENce " 1000000
<br />..." ""'-'-.-'-"'.--""-"-.,..---------._w_--
<br />fiRE DAMA(¡e CAny""",llrtI) $100000
<br />'~""-"""'----'---"-'-~'--'--'-'--'-----
<br />...!",ED E)(I' (An,V o~.~.8f8on).~5QQQ_.._----_..__.
<br />PERSONAL & ADV INJURY $1000000
<br />___n'._,__---.-. -----.-.. . ..... '...
<br />GENERAl, AGGREGATF- $ 3000000
<br />~---_.-
<br />PRODUCTS: COMÞ/OÞ AGG $ 3000Q.OO.
<br />
<br />,-----.-....--
<br />
<br />- ..--.--.-..---..-_u....-...
<br />
<br />.'.:.'., :\'?s,êGAT!: LIMIT APPI.I¡¡:¡; PER:
<br />:.>' ,'-, j~T ,-- LOC
<br />,^.:JTC'~~06'~E LIABILITY
<br />ANY AUTO
<br />ALL OWNED AUrOS
<br />
<br />COMeINEO SING1.F. I.IMI'f
<br />lEa QQCldent)
<br />
<br />$1000000
<br />
<br />-----_._-_...,._...._._...~- -----......---..--.--..-.-
<br />
<br />!
<br />, ,/!\
<br />
<br />: . SCHEDULEO AOT09
<br />, ,-: i H!!'!É:J AUrOS
<br />
<br />BODIl V INJURY
<br />(plJI" plJr~on~
<br />
<br />$
<br />
<br />-...-----...---...---.. --------..
<br />
<br />J"
<br />
<br />~.::'\.tW~'EO AUtOS
<br />
<br />Blf.01497314
<br />Blt01497314
<br />
<br />06/01/03
<br />06/01/03
<br />
<br />06/01/04
<br />06/01/04
<br />
<br />130011,'" INJURY
<br />IP9r ecçldenl}
<br />
<br />$
<br />
<br />-..----..-.------..------
<br />
<br />1'..'"'"""1 .--.----..... __.._m_......---...- ....
<br />
<br />PROPERTY DAMAGE
<br />(1'9r eççldent)
<br />
<br />$
<br />
<br />:-. -"'¡ DEOUCtIBLI:
<br />! R~.!1.NTION
<br />
<br />~
<br />
<br />AUTO ONLY - EA ACCIDENT $
<br />.... . .._,-- .._n.. ...
<br />Oll-lER THAN F.A ACe $
<br />.....-..----- ---..----.--..-.-----.-.
<br />AUTO ONL V; AOG $
<br />EACH OCCURRENCE $
<br />-.-.----,..---..- ----_._---
<br />AGGREGATE $
<br />-------...-.-.-.------ ------
<br />$
<br />------_.- ---
<br />$
<br />$
<br />
<br />-.----..-.,-- -....".
<br />
<br /><3ARAGE LIABILITY
<br />ANY AUTO
<br />
<br />..~''''---.................
<br />
<br />-...~?n,.'~
<br />
<br />c,-:::ÇUF.
<br />
<br />:_..1 CtAItw1$ MA"F.i
<br />
<br />\'.'~,''':.~S C~MF'ENSATION ANO
<br />. ~~\",,:,:v~~':!:' :_'A~~".~
<br />
<br />1490453-02003
<br />
<br />07/01/031
<br />
<br />
<br />07/01/04
<br />
<br />X _I(>J~U.!M!JL._.ER
<br />.!'~~.:.t:~CH ACCIDENT .. --~'!P_QP'.Q.Q..Q---
<br />E.LOISEASE-EAEMPLOYE $1000000
<br />.-......- ----,-.------..-
<br />E.L. DISEASE - POLICY LIMIT $ 1000000
<br />
<br />.O'1'I4ER
<br />
<br />'>0 ...~. \ ()O O"'2QATlONSlLOCATI')NSNEHICLI!òS/EXCLUSIONS ADDED BY ENDORSEIIENTISPECIAI.. ~C NISIONS;\ » p ¡:~ () :. if"
<br />~,'< '::~=CAT:¡¡: HOLDER IS AN WPITIONAL INSUlŒD WITH RESP¡:CTS J'iJ:I6 GŒNBRAi::--
<br />: ~:'.::~\:B:::"¡'I'Y OVERA.QE ~ ø-- J
<br />C ~~
<br />
<br />Lauf;¡ :~¡¡l.'i,:í..!V
<br />
<br />
<br />D..:puly Cil\' ^11(1rncY
<br />
<br />- -, .,.-"..s .:,....;: ~O'-OER
<br />
<br />Y ADDITIONAL INSURED; INSURER lETTER: A
<br />BLAmCOa
<br />
<br />CANCEL ..A TION
<br />SHOULD ~ NY 01' THEt ABOVe; 1;II;9CRœ"D POI.ICIES !IE CANCI!LLEO BEI'ORE THE EXPIRATlON
<br />DATE THe ~EO~, THI! ISSUIMG INSURER WlU, eNDEAVOR to MAIL _3..0- DAYS WRITTEN
<br />NOTICE TI I THr; CERTIFICATE IIOI..DER NAMED TO tHE LEft. BUT FAILURE TO DO so SHAI.I.
<br />IMPOS15 ,.) OSUGAT10N OR I..JAB/uN OF ANY KIND UPON T~E 1 \I!lURER. IT9 AGt:NTS OR
<br />RIõt'R:¡¡$EIITATIVES.
<br />AU~" ~ENTATlI/E
<br />
<br />City of Sant:a Ana
<br />Santa Ana City Jail
<br />Chris Laug@naur, Con~raC~B
<br />62 Civic Cent~r Plaza
<br />g~r.tà Ana ~, 92702
<br />
<br />Don
<br />
<br />hno
<br />
<br />@ACORD CORPORATION 1988
<br />
<br />.",C'ORi) ~~.S ('7197)
<br />
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