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Inauranc• Services <br />Of i'housatiid Oaks, Inc . <br />PO Box 732 9 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDEl7. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Thousand Uaks CA 91359 <br />Pho>z>~: 805-495-4634 1}'ax1805-494-0781 <br />INSURERS AFFORDING COVERAGE I NAIC9 <br />-- <br />INSURED / <br />~DO ~f ~6 rte/ <br />` <br />` <br />' INSURER A: t'$IC Insurance Ca. ~ <br />' <br />N <br />T [ <br />r INSURER B: <br />Castle eta o '"~"R~~c• _- <br />~ <br />- <br /> <br />4062 'Morn~ag Star Dr. <br />tTuntia <br />tQn EeaCh CA 92649 _ <br />_ <br />_ _ <br />INSURER D: <br />- - <br />g - --• --- <br />INSU RER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVEFOR THE POLICY PERIOD INDICATED. NOTWITHSTANgINa <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THETERMS, ExCLUSIONSAND CONDITIONS DF SVCH <br />POLICIES. AOOREOATE LIMITS BROWN MAY HAVE SEEN REDUC>=D BY PAID CLAIMS. <br /> <br />LTR <br />NSR TYPE OF INSURANCE <br />PpLICY NUMBER <br />DATE hA F pp <br />DATE Mhll <br />LIMITS <br /> GENERAL LIABILITY I EACH OCCURRENCE ~ s 1000400 <br />A X }{ COAOMERCIALGENERALLIABIL]TY INgCEl3Z6 02/213~D4 D2~28~D5 pREMISE~S Easnca} 3 3QD000 <br /> <br />CLAIMSMAOE ~ OCCUR <br />MEOEXP(Anyoneperson} _ <br />S 5000 <br /> <br />__ <br />PERSONAL3AW INJURY _ <br />S 1000O0D <br /> _ GENERAL AGGREGATE 3 2000OOD <br /> GENLAGGREGATELIMITAPPLIESPER: PRODUCTS•GOMPIOPAGG S 2000000 <br /> POLICY J6CT LOC <br /> AU TOMOBILE LIABIWTY <br /> L'OMBINED SINGLE UMR <br />S <br /> ANY AUTO (Ea accident? <br /> ALL OWNED AUTOS BODILY INJURY <br /> <br />SCHEDULED AUTOS <br />(Per person) S <br /> I <br />I <br />-- HlREO AUTOS <br /> <br />NON•OWNEO AU705 <br />BO DRY INJUF2Y <br />(Per accident) <br /> <br />5 <br /> PROPERTY DAMA <br /> - -- GE S <br /> {Paraaidenq <br /> i ~ G~ARAOE LABILITY AUTO ONLY • EA ACCIDENT S <br /> ' ANY AUTO EA ACC <br />OTHER THAN __ S <br />- <br /> <br />AUTO ONLY: AGG -- <br />. <br />I S <br /> EXCES$lUMBRELLA LIABILITY EACH OCCURRENCE S <br /> OCCUR ~ CLAIMS MADE A <br />TE <br /> DGREGA <br />S <br /> S <br />- _ - <br /> DEDUCTIDLE 3 --. _ <br /> RETENTION 5 = -- - -. <br /> WORKERS COMPENSATION AND <br /> <br />EMPI.DYERS' LIABILITY I ~ _ T RY LIMI_TS ER <br />( ANY PROPRIETORJPARTNERIEXECUTtVE E.L. EACH ACCIDENT ' S <br /> OFF! ERIMEMBER EXCLUDED? <br />~ E <br />L <br />DISEASE • EA EMPLOYEErS <br /> H y~s. tlescribe antler r- ~ <br />, <br />~ .. . <br />. <br /> <br />SPECIAL PROVISIONS below _ <br />~ . <br />. -. <br /> E.L-DISEASE-PDLICY UMIT 5 <br /> <br />I OTHER <br />pESCRIPTION OF OPERATIONS f LOCATIONSlYEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br />The City of Santa Ana, ita officers, agents and employees airs named <br />additional insured. 10 day notice of cancellation may be given for <br />non-payment. <br />C <br />ERTIFICATE kIQLDER ceNrl=- ! nrlnu <br />~+~.r~ SHOULD ANY OF THE ABOVE DEIfCRIBED POLICIES BE CANCELLCD sERC+RE THE !%riRATION <br />The Depot dt Sarita AAi OATFTHEREOF,THEIS3UINGlNSURERWI1Lni11^°""^^TpMAIL 30 DAYSWRITT•:N <br />anta Ana $lvd. <br />S <br />it <br />$ NOTICE TO THECERTIFlCATEHOLDER"AMEDTOTHE F <br />, <br />u <br />I08 <br />e I <br />Santa Ana CA 92701 ~. <br /> ALffHORIZED REpRESEHTATIVE <br />ertnon ~c r~nn~mm <br />Visa Gra.zzle <br /> <br />z•d <br />L/ ) `Cp FORD CORPORATION 1988 <br />T~Qiil QSO~OT ~O 6i JeW <br />