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<br />N--;!.LD4- D6 7 <br /> <br /> CERTIFICATE OF INSURANCE ISSUE C1ATE tMwt:em'} <br /> 1328630 2/20/07 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY <br /> K & K Insurance Group, Inc. AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> 1712 Magnavox Way CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE <br /> P_O_ Box 2338 COVERAGE AFFORDED BY THE POLICIES BELOW_ <br /> Fort Wayne, In 46801 <br /> COMPANIES AFFORDING COVERAGE <br />INSURED COMPANY A <br /> LETTER GREAT AMERICAN ASSURANCE COMPA <br /> LADIES PROFESSIONAL GOLF ASSOCIATION <br /> AND ITS MEMBERS COMPANY B <br /> 100 INTERNATIONAL GOLF DRIVE LETTER <br /> DAYTONA BEACH, FL 32124l0n COMPANY C <br /> LETTER <br />COVERAGES <br />THJS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN lSSUeO TO THE INSURED NAMED ABOve FOR THE POLlCY <br />PERIOD INOlCATED, NOTVVITHSTANOlNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO <br />WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AfFORDED BY THE POUCIES DESCRIBED HEREIN IS SuBJeCT TO <br />ALL THE TERMS, EXCLUSIONS AND CONOlTIONS OF SUCH POLIClES_ LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAlD CLAIMS_ <br />CO_ TYPE OF INSURANCE ~ EFFECTIVE POUCY EXPIRATlON <br /> POUCY NUMBER TE (I,MtlOIYY) DATE'1/fNOCIIYY) LIMITS (In thousands) <br />LTR <br /> General liability 12,01AM 12,OlAM General Aggregate $ NONE <br /> A f.ii] Commercial General liability GLP0568996402 1/01/07 1/0l/08 Products-ComplOps AggJegaie $ 1000 <br /> o Claims Made &]OccUL P$'r$Ol1al & Adverlising Injury $ lOOO <br /> DOwner's 8. contraclors Pro!. Each OccUff~ $ 1000 <br /> 0 Fire Damage (Any one fire) . 300 <br /> Medil,.'al Expense (Anyone pefllOn) $ , <br /> Participant Legal Uability 000 <br /> Aulomobile Liability Combined <br /> o Any auto Single $ <br /> limit <br /> BAll owned autos Bod", <br /> SCheduled autos Injury $ <br /> roo <br /> B Hired altos Bod'" <br /> NOI'HMf1ed autos ~~~---""'''l\ $ <br /> o Gerage Liability Property <br /> 0 Damage . <br /> Ex.ceS5 Liability Each Aggregaffl <br /> 0 Oceurumce <br /> OOlhefthan Umb<el1e 10m> $ $ <br /> Workers' Compensation 21/;) , Statutory <br /> and / ) $ Each Accid~ll <br /> Employers' LlabUfty $ Dlsea$e-Policy Limll <br /> ,. $ ~""E~I- <br /> AD8.D $ <br /> Participant Primary Medical $ <br /> Accident Excess Medical $ <br /> Weekly IndemnitY $ X <br />DESCRIPTION OF OPERATIONSn..OCATIONSNEHICLESlRESTRICTlONSlSPECIALITeMS <br /> RE: KRIS OLSEN <br /> EVENT: GOLF INSTRUCTION <br /> CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED PER FORM CG20ll, <br />CERTIFICATE HOLDER CANCELLATIOlII <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE I <br /> CITY OF SANTA ANA, CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE <br /> ITS OFFICERS, AGENTS t EMPLOYEES & ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS <br /> REPRESENTATIVES WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO ! <br /> 88B W. SANTA ANA BLVD THE LEFT, BLIT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE <br /> SANTA ANA, CA 92702 NO OBLIGATION OR L1ABILlT~~~~N.ANY KI~- UPON THE <br /> COMPANY, ITS AGENTS OR REPR TATIV _ <br /> ^UTOORIZIiD REPR.ESE"'^1 . :e--: '/1 <br /> ; ~I <br />SL39 / U~ ) 1-> <br /> <br />JTHRASH <br />