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Jun 06 OS 11t28a Beaver
<br />Page f of 1
<br />1909)
<br />~'ertificate of Insurance
<br />685-3630 p.l
<br />~~
<br />Srw,-:.: Program
<br />fVamc Insured: n , ~t~3 j S~ ~_ IVPmed Additional Inaurcd:
<br />Adlerhorsr Sntemational, Inc. t'v t II _ a l ~ SANTA ANA (SPARTA)
<br />3951 Vtrnun Ave }~- ~C el Y' 20 Civic Ccntcr Pluru PO Enx 19RR
<br />Riverside, CA 925(19 Santa Anu CA 92701
<br />Certificate N SSAt'vi-0030
<br />Coverage s'ARTi•. 1Tda:'ih?i~-.~.'.''t~JC:i,i`,t:l'i.a~s'rrG,a'. GvtlcrG~:,~abi~ily-:iatnrul
<br />Can:ri.cr '.. e.lV r: £ . o,Ol ;: 40
<br />~~.w~:-,;ya t'~.rind~ i3l:h70`'c `3:r~'!il~~
<br />Insu:an~c('a;izr.f;er; ~eaa';t~aCnnq~sny
<br />Mxu~t:x Pr:' icp Epe V.iv:: Ja (c i l i i =:? ~)+i4 ;: i :.;i.:~. a lily::
<br />Limits S:!A011,00+1 r:,a;~,n:.Aggt:>gata t bi:.:c(:,ir'„ ::ach c~ccrrc:',c~ 161,cUJ,COii Prodt~cL,;Ccmplctcu operations ;
<br />SI,D.:~1.SCl P::rsonul ~ Advertising Injury/$,50,000 fire Uamago /Medical Payrntnta Excluded '~
<br />Ucductibles ~:1~.7 Bi h F^ror Ciaimnm including Loss Adjustmem f-.xpense
<br />~,S.00 Premium (Fully Earned)
<br />.~~'4 'a~,cafi'ullyE~rned)
<br />S7S.00 Certificate -, •: i?ully EurncJ)
<br />;Sa:~.l•; l'oralAmount -
<br />Terms & !.'.MO Canec!,ar!cns f,!IO',:Gd. Yrdlniuni, Ltne~ and ices arc fully earned ar incep[iou.
<br />Conditions 2. O^erSrbns and Raring L'asod: '['raiairg b:-9 &: N(;licu o0ieu:v im diy property. (A'o fmblic exposure 1.
<br />.~. lnn:r;i re~:a iii 4pllg ?.n9 !~Q::^° _}t ,~':."C"(
<br />J. A,'.r,rtin:;al :::ua,'~i(41:NotAp;!a_bl:.
<br />5. No Professional Liability Covengu provided.
<br />(i. KO 7l,'RLIi: F,XYOSURI~ WUKKING 14'I"fHIN'I'HE CITY OP I.OS ANCP.LFS pIPAR'!'MLNTS AND
<br />THEIR F,MPLOYFF.S ONLY,
<br />? N^ COVERAGE PROVIDED FUR ANIMAL MUR'fALI"I'Y OR DOG 6ITES.
<br />F,xdusions A::ncomr., Aa~uult & Rsttcly, Employer' Related Practices, Subsidence, Independent Contractors, Pollution. Crusa
<br />Seii, Lead a• Silau Dust, Mold or tjio-organic Growth or Mildew, Punitive Damages, Animal, yreaeh of Contr:mt,
<br />Y2K F_!eutrcnic turn. Mad~cal Payments, War or 9"errorisrn.
<br />'fhu insurance provided under this polity Is limited to vour work purlormed on behalf of the entity named us
<br />"Additional Numcd insured" above and doesn't extend iuelf to any other work pcrlbrntcd h}' you or yuta
<br />organization. Coverage is limited to the description of operations and ruing b;ucs lielal in "Terms .$ Cor,ditio(r'
<br />iwm 2.
<br />Per [he Muster policy, a copy is uvxilublc ny wvitren request 'rp: Municipality Insurnncc Services, htc.; i02 W'.
<br />Cerritos Ave.. I3uil(ling w7, Anuhcittr, CA 92R05
<br />APPROVE.,.` ~'~°~ if"> i'~est'vl
<br />J ~/ :~:~°~ ` --
<br />^-'r"7`"" .. ... /1.. "._.__ Carol Frost / v~~-sidtnt
<br />. ,,,_., ,.,, ~.,iy a.u orncy, Municipality Insuranct Services, Int.
<br />-3tJa'Y_~::~-,r-ia.n rN+Gt+U1ki NAd~n'I~IV•
<br />iD2 W. Corr+•.:• ~ '`1?' 7 Anaheim, CA 92805 (800) d"<:?•0~T5' !7! d? 6~Y?~ ! I Pl) fas (714) 6R7.1106 I,icensesCA:0C04R-09; OR:1954?3
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