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0 It 06/03/2004 15:59 8585190822 FITNESS AND WELLNESS PAGE 02/03 ACORD DATE (MM/DDNYYY) ,A CERTIFICATE OF LIABILITY INSURANCE JUN 304 PRODUCER THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION FITNESS AND 1 (ELLNESS INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 380 STEVENS J VENUE, SUITE 206 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR SOLANA BEAC i CA 92075 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # — - Agency, Lie#: OD28716 INSURED INSURER A: ZURICH AMERICAN INSURANCE CO. PAUL H. F 'TIERS INSURER 8: - -- _._ DBA THE' RAINING SPOT 7602 ONTj RIO DRIVE INSURER C, HUNTINGI ON BEACH CA 92648 INSURER D; – INSURER E: COVERAGES THE POLICIES OF ISURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POI.ICYPERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHfCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREG TE LIMITS SHOWN MAY HAVE BEEN REDUCF13 BY PAID CLAIMS. MSR ADDIL TYPE( r INSURANCE I POLICY NUMDr;R POLICY EFFECTIVE POUCYEXPIRATION LIMITS INS DATE (MMIDW"l 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILLIRETO DO BO $HALL IMPOSE NO OBLIGATION OR LIABILIYYOF ANY KIND UPON THE 20 CIVIC C ENTER PLAZA GENERAI LIABILITY EOL901232MO MAY 3104 MAY 3105 EACH OCCURRENCE 1,000,000 $ 100,000 X COI MERCIAL GENERAL UABILITY _ . lCLAIMS MADE OCCUR DAMAGE TO RENTEp .P_RF.WC.F6 (EA.occum MED. EXP (Any one person) $ 2,500 $ 1,000,000 A PERSONAL &ADV INJURY $ 3,000,0_0_0 GENERAL AGGREGATE GEN'L AG ;REGATE LIMIT APPLIES PERI ...X PRODUCTS•COMPIOP AGG. $ 3,000,000 I POL :Y f7 PROJECT LOC AUTOMO ILE LIABILITY I AN) AUTO I COMBINED SINGLE LIMIT (Fa owdem) $ ALL )WNEO AUTOS BODILY INJURY — SO 17ULED AUTOS (Per person) S HIR D AUTOS NOI -OWNED AUTOS BODILY INJURY (Per soCldent) $ PROPERTY DAMAGE Peretddem GARAGE AABILtTY AUTO ONLY - EA ACCIDENT — OTHER THAN EA ACC AN, AUTO $ AUTO QNLY: $ EXCESS, UMBRELLA LFABILITY EACH OCCURRENCE $ 00, UR �. —1 CLAIMS MAGE .$ _--- AGGREGATE -- ` DE( JCTISLE RE' SNTION $ _......—. Is WORKERS COZY 'IRNSATION AND EMPLOYERS' LI YBILITY ANY PR0PRIWMF 'ARTNEIWXCurnE iRL' �' ` KiJ.. / 1 WC STATU- UMD:S OTHER - E.L. EACH ACCIDENT S E.L. DISEASE•EA EMPLOYEE OPPICERIMFMOEF EXCLUDED? $ - lfyff, fAfarlhf um it SPECIAL PROVIS14 43 bolew - E.L. DISEASE -POLICY LIMIT $ OTHER: DESCRIPTION )F OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS THE CITY OF S 1NTA ANA, 20 CIVIC CENTER PLAZA, SANTA ANA, CALIFORNIA 92701. ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESE dTATIVES ARE NAMED AS ADDITIONAL INSUREDS WITH REGARD TO LIABILITY AND DEFENSE OF SUITS ARISING FROM THE OPERATIC NS AND USSES PERFORMED BY OR ON BEHALF OF THE NAMED INSURED. mmnrlvrAr 1^1 nam ACORD 25 (Z( )1108) Certlfic2te # 3037 OD28716 V ACORD CORPORATION 1988 r1) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENOEAVQR TO MAIL SO CITY OF S ►NTA ANA DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILLIRETO DO BO $HALL IMPOSE NO OBLIGATION OR LIABILIYYOF ANY KIND UPON THE 20 CIVIC C ENTER PLAZA INSURER, ITS AGENTS OR REPRESENTATIVES, SANTA AF 4, CA 92701 AUTHORIZED REPRESENTATIVE erl Attention: Jeffrey E. Frick, CEO ACORD 25 (Z( )1108) Certlfic2te # 3037 OD28716 V ACORD CORPORATION 1988 r1)