|
<br />. I ~l!;.ORDN CERTIFICATE OF LIABILITY INSURANCE ....e 1 of 2 1211~;~00.
<br />tpRoi..IR 877-U5-7378 THIS CERTIFICATE 1818SUED AS A MATTER OF INFOIlIIATlON
<br />. ,,,,, Y AND CONfERS NO RIGHTS UPON THE CERrIFlOA"TE
<br />. --R THIS CERTIFICATE DOES NOT AMEND EXTEND OR
<br />
<br />W~~..g AY~~Q ~claG. ....uo.;. - ~~~~ ~4X~ ~~~... .;:":"--1..11;.. . . '
<br />26 C..t.v.zy Blvd.. ALTliR TIlE~COVERAGE ""=,",0'"
<br />P. O. 8cac lOSHl I
<br />NlIabvill_, TN 3123051'1 INSUREIl'J AFFORDING COVERAGE NAtC'
<br />--- )NSUREAA.: 'Z'U.:d.ob ~rlclm la,auaae. 1:_
<br />INSulteD SobiDdlaX' .levat.or corporatioa. ln35~IJD3
<br />20 Wh!:loaray 1b'!ad JJ -;;(D03-/3/ IN$UAER 8-
<br />1Iw'r1.tOW# . IfJ 0"'0
<br /> INSU!'lEFlC,
<br /> IV -dOG?,- 81-0/ INSUAEA D: .
<br />, INSUAliiFl~
<br />
<br />CO' 'iRAQES .
<br />rn E POllCIES OF INSURANCE USTEO BELOW HAve BEEN ISSUED TO THe tNSURED NAMED ABOVE FOR 'rHr::: ~.,-_" :.. - c:"-:;:,.
<br />, n" ~.~". ":'~,o~::~ -""'':'''--' ,-'co, .",.:""~,.-",...,,.. ;'.':'_<-,-,~-,,":"~,,'~'" ~'"' ......- ,-:,:",.., :XUMENT WITH RESPECT TO WHl~ TH1:> Q:Hllt-lt;A1t: N!F\Y tn: 1~~ UH.
<br />~.: . .. u_ - - - - ,'-.::.-:-.:..;;:::;:..:.... ..,_.. _ __, _".' :-.-.: :.:~;. .. .--.~, _. __-~,."'_'.-. ,:"':",:!N ISSU8.JECTTO ALL THE TERMS. ExCLUSIONS AND CONDITl<>>JS OF SUCH
<br />~)lIQE'S'iiGMEGAiEl:"'''iTSsH(jWNMAV HAve BS9'-REOUCEf.~..' ~:;.;.. . ~ ".""
<br />
<br /> --. ~------ -~t'--'" ---......
<br /> - I I
<br /> '-"';".~:;1 NUMBER U,,"O
<br /> -- -,- !
<br />IA ~~UAIlUTY 0006..5.3515 1a/31/aOQ' 11/112006 B4}:~"~ --.....
<br />! 'J.. 5liRCIALGENERALLIA8IL1TY I I . "A" "M
<br />i _ CLAIMS ;.;AOE [i] ~ I MEDEXPlAillifJlltbioii.ili'l1 ,
<br /> A.. Cem.1:rikbt.ua:;r.... n n.t, hI I "R$ONAlft.N:NINJUf\Y . . ~nnn.M"
<br /> - I g~NEfl/ol.-.ac--AEGATE . '~nnn. 0"0
<br /> ~~=nE=AP~r: PRQDl..CTS. CCWI>.()P AGe . ",oCO.OOO
<br /> .. ~TOIIOIN\,I1. LJAIIUTY 1lAP6.'5U615 la/31/200.!1/1/2006 I \'VMUi~ ;);i...w .._.,
<br /> 1a/31/200' 11/1/200& (EalCCllJMt) . ~,ouo,ooo
<br /> .. -X ,"y"",,, KA6t454":J15
<br /> .. - AU OWNEOAUrOS '1'Al'6U54U15 1a/31/200. I 111/2006 900lLYlNJUAY
<br /> .
<br /> $CHEOULEDAllTOS [...,J*UlI'I)
<br /> :i HIFlEDAlJTOS BOOILYI.uUl'l.Y
<br />L , (PtrWlltei\lI .
<br /> ;IL NON-OWNi:DAUTOS.
<br /> I- - PROPERTY CAMAQ.E .
<br /> (~~
<br /> CrOUA1Lm AUTOONl..Y'''AACC!OENT .
<br /> ANV"Vl'O OHERTHMI ~IICC I
<br /> AUTOON..V. .00 .
<br /> PC". u....IUTY I!;AOHOCClJAAE.NCE .
<br /> ::rOCCUA 0 OU\J"""""E AClGA~'T; .
<br /> I
<br /> ~ DEDUCTIBLE -- ...!...-_.-.
<br /> RETENTION I ~ .
<br /> A WORK-liAS COMPSNSA TtQN ANO *,6U"3816 12/31/2004 111/2006 1"1l1'
<br /> QIPlOYIM'UAIIUTY
<br /> A "'-NY PAOPRlE'TOM'AATNERlEJlCECUTlVE WC666818714 12/31/2004 1/1/2006 e.L EACttACtIOtNt . 1. 000, ODD
<br /> OFFlCERlMEMSER rXCWO~tl1 i.!. OI8CAS6.1A EMPLO'I'iE S 1. 000. oon
<br /> I- ~~~~~SbeloW U. OI8EASe. POlIOYUMIT . , .nnn.OOO
<br /> orl-lll!"
<br /> I
<br /> IE CRIPIlON OF Oft:MTlONSILOCATIONllVEHlCLEtlDCLU8tON& ADIlI!D.'t ENDORIeMENTltNCtAl MDVISIONS
<br /> _:8510 - COHT ..3-13594
<br /> JIA,' ~R'r.DiIUICa AT SANl'A ANA. RZGIORAL "l'RUISPOR'!'A'J":tOllI CDP1'B1t., 1000 BAS'1' _.. .utA. BLVD., S'1'II. 101,
<br /> Al ftA ANA, CA 92701. lWl)1'nClUo1. DlSllUD. '1'RB CI'l'Y or SAlft.I. AIG., %'J'S OITXcaal DIl'LOYBB8 ,
<br /> M:QI'1"S AND gPRBSDJ'TAT:IVB8 AS :PD ATTACHE)) ADD:J:T:J:ClIIAL :rtf8tJJtBD DmOa8B1111lft'.
<br />
<br />CERTIFICATE HO~I)ER
<br />
<br />CANCELLATION
<br />tH()IJL.D ANY i)1= THlAIOVI! DIIIC~.ID POUCH 8Ii CAJiC:ULm 8EI'O"! T1IIIXPIU.TION
<br />OAT!: TltER!OF, THE ISIUWQ IN8UflI!ft 'MU "'----fltAlI.. ~ nA,YS WlltTliN
<br />N011OETOTltCCUtTFIOAT!HOUlPlNoUlI!DTDTHl:lD'~ --_. _.. __II,
<br />
<br />..____b.- ...
<br />
<br />----
<br />
<br />_<=lll....--...--...
<br />
<br />ex,", OP Pma >>(I., JlDJtCIIA$IING DIVI'IOIl, 11-16
<br />:zO CIne esma l'LAUt.
<br />IAlft'A AKA. 0 9270:2
<br />
<br />JiI u..-...
<br />
<br />AU1NORIDD .
<br />
<br />'3"'-. ..
<br />~J'd-y
<br />
<br />AUIRO 25 (2OO11OS)
<br />
<br />COll'1167132 'l'pl.33&926 Cere: ~'C.
<br />
<br />APPROVED AS TO FORM
<br />
<br />~()Y~/)5
<br />
<br />I' Laura Stitt S edy
<br />Assistant City Attornev
<br />
<br />2'd
<br />
<br />y:I"YY1
<br />
<br />"E2'SO SO ~Y qa~
<br />
|