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FROM FITNESS AN: WEL'_NESS INSURANCE (TUE)MAR 14 2066 16:24/3T.16:22/k.6820420062 P 2 <br />ACORDTM. CERTIFICATE OF LIABILITY <br />INSURANCE DATE(MM/D0lYYYY) <br />PRODUCER Phew; (800)795.8075 FAK. (858)SIU.Ca 2 <br />TYPE OF INSURANCE <br />FITNESS AND WELLNESS INSURANCE AGENCY <br />THIS CERTIFN:ATE IS ISSUED AS A MATTER OF INFORMATWN� <br />STEVENS AVENUE, SUITE 206 <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />30 ANA <br />SOLANA BEACH CA 92075 <br />BEACH <br />NO MR. TINS CERTI alk DES 1001 AMEND, EXTEND DN <br />CMlA-- --FORDED BY <br />GENERAL <br />INSURERS 7AIFFORROING 71nsurance NA IC e <br />OD28718 <br />01/24/08 <br />INSURED - <br />INSURER A: Company <br />KARATE DO NW <br />X <br />CIO MARTIN TORRES /V— ,�2(;'( %� - -C� %✓ <br />-- _._.......__._..._ <br />12892 RANCHERO WAY <br />INSURER C: <br />GARDEN GROVE CA 92843 <br />INSURER D' <br />INSURER E: <br />COVERAACa <br />THE POLICIES OF INSURANCE LIVED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG <br />ANY REOUIREMEN7, TEAM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORUED BY THE POLICIES DESCRIBED HEREIN 16 "JECT TO ALLTHE TERMS, EXCLUSIONS ANO CONDITIONS OF SUCH <br />POLICIES AGGREGATELNITS SHOWN MAY HAVE BEEN REDUCED BY PAID CIAAAS. <br />LTR <br />^ <br />TYPE OF INSURANCE <br />PDLICr NUweER <br />PIILICY Iasecrrve <br />IM7E <br />roueruuluTlN. <br />"W <br />UNrcd <br />A <br />GENERAL <br />LIAMLITY <br />COMMERCKI.04NERALLAWLITY <br />C1ANI6 MADE OCCUR <br />E01.9012327 -01 <br />01/24/08 <br />01124107 <br />EACH OCCURRENCE <br />f 1,000,000 <br />X <br />IV ETOREMED <br />.." RGM <br />i 100,900 <br />MED. EXP (ADy mr p1K.PAJ <br />PERSONAL &ADVINJURY <br />f 2,500 <br />S 110001000 <br />GENERAL AGGREGATE <br />$ 3,000,1000 <br />OEKLAGGREGATE UMITAPPLIES PER. <br />7X POUCY JECT LOC <br />PRODUCTS-COMPIOP AGO, <br />i 3,000,000 <br />AUTOMOBILE <br />LABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ee IICLI(iNII) <br />i <br />ALL OWNED AUTOS <br />BODILY INJUfiY <br />SCHEDULED AUTOS <br />(PAI PeramG <br />i <br />HIRED AUTO$ <br />NON-OWNEO AUTOS <br />BODILY INJURY <br />(Per Om.IEeIN) <br />f <br />PROPERTY DAMAGE <br />Pa er68Hf <br />i <br />GARAGE UIIBYTY <br />AUTO ONLY• EA ACCIDENT <br />i <br />ANY AUTO <br />OTHER THAN EA ACC <br />f <br />AUTOONLY: AGO <br />f <br />= RCISSI UMeN!LLA LIABILITY <br />OCCUR CLANS MADE <br />EACH OCCURRENCE <br />3 <br />AGGREGATE <br />S <br />9 `- <br />DEOUCTIBU°. <br />f <br />RETENTION 7 <br />YlgRl(ERBCOePENSATWMAND <br />EMPLDYERa LABILmY <br />RawTaecunvE <br />E ■AIIUUa..INN <br />FRGVMIOIM <br />vACU1t E.N. <br />_..1 <br />�- <br />wciTATV OTHER <br />TORY LI41IM <br />E.L. EACH ACCIDENT <br />E.L. DISEASEE.A EMPLOYEE <br />f <br />S <br />E.L. DISEASE-POLICY UNIT'.. <br />y <br />OTHER: <br />DESCRIPTION OF OPERATIONS /LOCATIONSIVEHICLESIEXCLUSIONS ADDED SY ENDORSEMENTI SPECIAL PROVISIONS <br />It is understood and agreed that the following entity Is added as an additional insured but only es respeCIIS the operations of the named Insured <br />except that liability resulting from the additional insureds sole negligence. <br />1012TIGIn.7 u <br />yALWCELLATKTN <br />^....TV w IAVVNUS) Venricareq 37174 0 ACORD CORPORATION 1998 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO GAIL 30 DAYS <br />The City of Santa Ana, its officers, <br />WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE To <br />DO 50 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS <br />OmplOyeea, agents *Od repnNHmtali"*, <br />AGENTS OA REPRESENTATNES, <br />P.O. Box <br />AUTHORIZED REPRESENTATIVE <br />C 927 <br />Santa Ana CA 92702 <br />Attention' <br />Jeffrey E. Frick, CEO <br />^....TV w IAVVNUS) Venricareq 37174 0 ACORD CORPORATION 1998 <br />