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<br />Ma~ 20 04 02:32p <br /> <br />,..2 <br /> <br /> BRANCH! <br />21 I <br /> <br />BIA <br /> <br />PRODUCER NUMBER ¡DATE OF ISSU ¡RENEWAL OR REPlACEMEN1~ <br />0003252 (21.0) , 12/2/2003 NEW ' <br />SPORTS GENERAL LIABILITY POLICY <br />OCCURRENCE POLICY <br /> <br />PURCHASING GROUP POLICY NUMBER: GL2-3000101 <br /> <br />Item I DECLARATIONS <br />,. <br /> <br />CERTIFICATE NUMBER: GlS - 2031104 <br /> <br />Named Insured <br />ADDRESS <br /> <br />. <br /> <br />. <br /> <br />Tustin Malllal AIls <br />7133 Grove Wood Jane <br /> <br />~/iSIr~I. TOWI\C~. Stale & Zip No. <br /> <br />. <br /> <br />Orange. CA 92859 <br /> <br />2, <br /> <br />Policy Period; <br /> <br />11/24/2004 <br /> <br />From: <br /> <br />11/24/2003 <br /> <br />To <br /> <br />3, <br /> <br />COVERAGE <br />Sl)04'1sGer¡ørlllliøbilily! $ <br />S ',000,000 <br />S 50.000 <br /> <br />11;0 I Ä-M, SlarxJørtf Tlm~ ðI LOCl1liOI1 of Promi'iot Dœ;g"aleo" ¡nllBm 1 <br />LIMITS OF LIABILITY <br />9ChOCCUITMCe ¡ $ 2.000,000 <br /> <br />s <br /> <br />PREMIUM <br />385.CO <br /> <br />1.000.000 <br /> <br />i99fe9ðte <br /> <br />i $ <br />Is <br />0 <br /> <br />PI:'f'5Of'.aI and Advertis'ng l.iab4111y <br />Fire Damage {any ane fire) <br /> <br />2,OOQ,ODO <br />0 <br /> <br />PtoøllC~S < COm )Jeled ap.raUons AggIl'lQil'It <br />MediCsl Expet1$Q (arlyooo Person] <br /> <br />; T errori:sm Risk In:sural1ce Act . CertifMtd Acts Caverðge <br /> <br />[!] NOI COVèred <br />Minimum Earned Premium <br /> <br />Covered <br /> <br />$ 0,00 <br />$ <br /> <br />300.DO <br /> <br />4. <br />5. <br /> <br />Deducttble <br /> <br />S <br /> <br />NONE <br /> <br />, eM':h occurrence <br /> <br />R~tIcm: The Named lnsu~ ~esents tI1at accident Insu~nœ m tht! al'nO\lrlt 5 )@C1f1edwlll be In fuO force and ~ct d each partlCiPM"lt in My"nd al) athletic <br />; pi"QÇrøtnS covered by Ihls policy. <br />AcCIdetr.lll$U"atlCCfeøresent:e<!iII1UhJnt: <br /> <br />$ 25,000 <br /> <br />6. <br /> <br />This policy ~ urddt! <ill(:! ðCceptpd S"lJbjed to the printed WnditlCn$ in thiS pOlICy tuget/Jer with l/'Ie ørOvisioos. Stipulatlol1$aM òç¡reemertt$:«)ntain in the fOl/owlr11l <br />. fgrms(s) or endorSfl!mefTt(s). <br />I' GLD-2065{09/96).CG0001 (0 1/96),ClE-2002(12197),ClE.8049(06199),GlE-2013(03/W).CG2147{1 0/93),llOO03(11/85). <br />IlooI7(11196),llOO21 (11185),EUE-8050(OI1114).GlE-8060(04/00).GlE8023108193).GlE8046(1 :1I96),CG2135(10103 ¡.CG <br />: 2026( 11165),MSE~6001(2/95), .GL3879(1/03) <br />I <br /> <br />CHICAGO INSURANCE COMPANY <br /> <br />EXECUTIVE OFFICES: 55 E. MONROE STREET. CHICAGO. ILLINOIS 60603 <br /> <br />REPRESENTATIVE <br /> <br />Agent or broker <br /> <br />Midland Insurance Group, Inc;. <br /> <br />Office Add res! <br /> <br />1730 Park Street Ste. 207 <br /> <br />City. State. Zip <br /> <br />Naperville, Il 60563 <br /> <br />I <br />I <br />: Additional 2% CA 8urr;'- . 'I 'Îì\ <br />, '''Ip~~ <br />! <br /> <br />INTERSTATE <br />INSURANC <br />GROUP <br /> <br />j GlP 2010 (01/D3) <br /> <br />I <br /> <br />~7 <br /> <br />p.2 <br /> <br />Ifh'r <br />