|
<br />Ma~ 06 04 01:41p
<br />0~10512BB4 11:15
<br />
<br />p.2
<br />
<br />B5B5190B22
<br />
<br />FITNESS AND WELLNESS
<br />
<br />PAGE
<br />
<br />021B3
<br />
<br />~
<br />TM
<br />
<br />DATE (MMIOO/VYYY)
<br />CERTIFICATE OF LIABILITY INSURANCE MAW.
<br />
<br />THIS C&RmrcA.TE IS ISSlIED AS A MATTeR OF INFORMAnON
<br />ONLY AND CONFERS NO RICIoIU UPON TME CERTlFICAn
<br />HOLDER. THt8 CERTIFiCATE DOES f'OT AMEND, EXTEND OR
<br />At TER TH COVERAGE AFFOR ag 'V THE POLletn r!L
<br />
<br />PAo!'>UCtR
<br />FtTN~SS AND WI LLNESS INSURANCE "G~NCY
<br />:ItiO STEVENS A~ ,NUE, SUITE 206
<br />SOlANA BEACH ;A 92075
<br />
<br />INSURERS A.FOIIOING COVERAGE
<br />,~ A. Z.urlch AMerican InsU1'an<:1 Complny
<br />INSURER B
<br />INSURER C
<br />INSURER [):
<br />'NSIJFtER E
<br />
<br />NJ\ICIIf
<br />
<br />- - AgoncCUç#o 0028716_-
<br />
<br />':=J= .
<br />
<br />INSI,JREO
<br />LUIS F. SILl'
<br />802 N. NEW lOPE ST.
<br />SANTA AN. CA 92703
<br />
<br />_.----
<br />
<br />-
<br />
<br />'-
<br />
<br />--
<br />
<br />COVeRAGES
<br />"111@ I"OlICI£8 OF IN. UFV.Ncr LISTED BiLOW M\'£ eEEN ISsueD TO j)Œ 1NSU"'~ tU.MiD ABOVE FOR THE F'OI,¡CY PiRIOO fN01ÇA.T~O. HOTVtllTt'S'TANOING
<br />At« REQUlI't!MG.rr, 1iRf.,t OR C[)NJITI~N OF AN'" tON'TRACT OR OTHER gQCUMENi WIT'" R~!CT TO WHICH THIS C(;:RnFIÖA'TE M.av Ni: IsaUEO OR
<br />MAY Pf;RTAIN. THE I StJRANŒ ArfQROeO BY THt POLICIE~ Of;"$ÇRIIED HE"1i:1N IS sUBJECT TO ^Ll niE TERMS. uCl.U51O\IIS "NO CO"lOITIONS OF 9uç~1
<br />POllCll!S "GGReC:A" i LIMITS SHOWN WAY HAVE ~I;N Ri!ooCËD 1'( 11",10 C~1M6.
<br />
<br />N:: ~~~ TY1'E 01 HIUIlANCE
<br />O£tolERAll..Bt1.I1'Y I
<br />'~.)( , COOl iRCIAl OENE~l UA81L1
<br />I I ¡ I .AI"S MADEI~ or::CUR.
<br />
<br />-)-- "!
<br />-_I --.
<br />()EN'l "GCi :EêATE llN1T ,yP1JES P.R
<br />
<br />X POL\("----: Lor:
<br />
<br />AUTOMQD' .e 1J,AIIIlITy
<br />
<br />i~- , A.V uf.
<br />I P,LI.( oNNiD"lJTO$
<br />!.---= SCW JUlEDAU10S
<br />i-" I'II~' AUTOS
<br />NON )w~fD A.UTOS
<br />
<br />---_.
<br />
<br />--
<br />
<br />r~ -" "-"- --
<br />":.rw~",~" UNlIT!
<br />MAR 11 05 eCV"P;[Ncr "2 DOO,oOð
<br />I)I,t,UoOtTCIMoNniO - ;--" -10DOoo
<br />PREMl8U-MUllZw"hI!~'I-" .--...!.--
<br />M!!D.tKP(Al'Ivo"e~lI.~ I ~ 500
<br />---- ".-- I -~'.-
<br />,PER~NAl&AOVI]llJURV I, 2,DOQ.000
<br />I~AGG I[EGATE -:S- .,000,000
<br />PROouc'!'$.c~'OÞAM. '-I~ 4:i!°Q,0Q0
<br />
<br />CQMeINEO ~INGl.li I.tMtT
<br />:rtlt.¡;çIc ftI'It
<br />
<br />.
<br />,
<br />
<br />POUCV "UMIIR
<br />E0I.9012327.oo
<br />
<br />'",-ICVEFFl'C'11VI
<br />f
<br />MAR11 04
<br />
<br />A
<br />
<br />iBOOllY INJUI'I,V
<br />I(Pt'I"f1on)
<br />,
<br />1~II.YII'LJU"'V
<br />,{Pi!'I'ltcll$erol}
<br />
<br />-r---
<br />-----¡- --,
<br />I'
<br />,
<br />
<br />'I C,aUQ!, l "BIUTY
<br />,- 11\f>N ,UTO
<br />
<br />PRoPERTY DAMAGE
<br />f'iII)ftteelO8l1l
<br />AUT!:! ON\.v. EA ~CC:IOtNT
<br />¡OTÞI~ntAN _fA'" C S
<br />AUTO ONLY' S
<br />
<br />-~-
<br />
<br />---
<br />
<br />I i)(ϧt I ""IItIRLA UAlfl..lTY
<br />-! OCC IA. LJ Cl.A~Si IrMD.
<br />I
<br />,"-
<br />I D€:O 'C,1lQI.'E
<br />'-
<br />RE'r NTIO~S
<br />WOAK.eRS CO-' EN!lATION AlII )
<br />(WLbY'eRS'LI, glUT'\'
<br />""., '.II"II,'r.TOAI AII.'hllRlUŒ\lTlV'II
<br />OFI'IC\tUMuø.. m::luuE01
<br />"""I:IMC:IfM.~,
<br />,'~K!llilP'IIgV 1tC I~""",
<br />
<br />£AC!10CCVftf'g4CCii
<br />AOGR,ËG^TE
<br />
<br />'----
<br />
<br />.
<br />,
<br />.
<br />
<br />'--
<br />
<br />
<br />-----
<br />
<br />/'12-
<br />
<br />IWC,T"'1V- O"I""I!Ft !
<br />__lJollr.U'UlI--
<br />E.I., EACIoI ACCJO£NT ,
<br />--- ê9F
<br />e.L. 018EAS!-1!A I!MM,Cvn t
<br />P!..L.I)!S.ASIi.-PðlJCVI.IJ.!IT $
<br />
<br />--
<br />
<br />--
<br />
<br />--,
<br />
<br />on-4eR
<br />
<br />i I I I
<br />
<br />DESCRIPTION, IF OPERATIONSILOCATlONSNI!HICLESlEXCLUSIONS lIDDED BY iNDORSEMENTI SPECIAL PROVISIONS
<br />C~RTlFIC"TE I OLDER ADDED AS ADDITIONAL INSURED ONLY AS THEIR INTER~STS MAY APPEAR.
<br />
<br />C
<br />
<br />0 DE
<br />
<br />C~CE
<br />.9fíOlA.D ANY OF THi: AIP\Æ Df:SCR!I!III!D ~I.IC"S . CANCE1.\,£Q U~F~¡ TM¡
<br />EXPIIV.T'ION ~TE THfiPEOF. -me ISSUING (':OMPAN'" WILL MAIL 'JI) !UYS wl\11'Te1
<br />NOTICE TO ,...." C~TIf\<:.ATfj, HOLDER NAMeD TO THE IJiFT
<br />
<br />TH~ CITY 'F SANTA ANA
<br />2Q CIVIC C :NTER PLAZA
<br />SANTA N '. CA 92101
<br />
<br />,lWTHQRIZEO fI.
<br />
<br />¡C:N'f^TNE
<br />
<br />&.L ¿ ;hl;,.{
<br />/~. Frick.CEU
<br />0028716 @,ACORD CORPORAYION 1988
<br />
<br />AUcrnlion:
<br />
<br />ACORD 25 121 01/0')
<br />
<br />Certifícahlt
<br />
<br />10 0S
<br />
|