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<br />ACORD.. CERTIFICATE OF LIABILITY INSURANCE I DATE IMMlDDIYYYY) <br /> 11/4/2004 <br />PI" !.''"'' Sandra llaoclonald ~"OY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> 17141 Ventura Blvd. '202 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Bnoino, CA g1316 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> (818)g06-1042 <br /> INSURERS AFFORDING COVERAGE NArc. <br />lNaUIUID BBRNAIIDIIZ CART SJ:RVICIIS INSURER ANATIONAI.. LIABILITY , FlU INSURANCE <br /> BNRJ:( 1 J& IllilOliWDlIZ .t\ - J..004 -( 34 INSURER B: <br /> 1808 LZNCOLN BLVD. INSURER c: <br /> VllNZCII, CA g02 gl INSURER D: <br /> , INSURER E: <br /> <br />Policy Number: <br /> <br />Oslo Entered: 11/4/2004 <br /> <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING <br />ANY REQUIREMENT, TERM DR CONDITION OF ANY CONTRACT OR DTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE 8EEN REDUCED BY PAID ClAIMS, <br />POLICY EPPICTIYi. POUCY IXPUtAT10N <br /> <br /> <br />POLICY NUlØER <br /> <br />....... <br />EACH OCCURRENCE $ <br />PREMISES Ea oca.nl'lOØ $ <br />MED EXP (Any one person) $ <br />PERSONAl & AOV INJURY $ <br />GENERAL AGGREGAiE S <br />PRODUCTS - COMPIOP AGG $ <br /> <br />GENeRAL UA8tLITY <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE D OCCUR <br /> <br /> <br />LDC <br /> <br />AUTOII08LE UAØlUTY <br />ANYAUTO <br /> <br />COMBINED SINGLE LIMIT <br />(Ea acOdeOt) <br /> <br />s 1,000,000 <br /> <br /> <br />AU. OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NQN..QVYNED AUTOS <br /> <br />73APN289214 <br /> <br />11/2/2004 <br /> <br />11/2/2005 <br /> <br />BODILY INJURY <br />(Per person) <br /> <br />. <br /> <br />A <br /> <br />BODL Y INJURY <br />(Pw acådenI) <br /> <br />s <br /> <br />IXCE88lUMBRELLA LIAIILITY <br />OCCUR D ClAIMS MADE <br /> <br /> <br />PROPERlY DAMAGE <br />(Per accident) <br /> <br />AUTO ONLY. EAACCIDENT <br />EA Ace <br />AGO <br /> <br />s <br /> <br />ØARAGE UAllLITY <br />AN'( AUTO <br /> <br />OTHER THAN <br />AUTO ONLY: <br /> <br />s <br />. <br />s <br />s <br />. <br />s <br />. <br />. <br />OTH- <br /> <br />",.Qld~ <br /> <br />EACH OCCURRENCE <br />AGGREGATE <br /> <br />DEDUCTIBLE <br />RETENTION S <br />WORKIRS CQIIPENSATION AND <br />EMPLOYERS' UA8IUTY <br />AN'( PROPRIETCIIUPARRÆJCEaJ11VE <br />OFflCERIMEMBER EXCt..UCED? <br />''''.-''- <br />SPeCIAL PROVISIONS below <br />OTHE." <br /> <br /> <br />E.L. EACH ACCIDENT . <br />E.L. DISEASE. EA EMPlO'IEE . <br />E.L. DISEASE - POL!CYLlMrr s <br /> <br />DIICMI'f'IOWOP ONItATIOQ I LOCATJOtI8/WHlCLIS I UCW8M)118 AD08D 8Y .ROOMIlt!NT IINCIAL PROYII8OtI8 <br /> <br />CIIRnFZCAft BOLDIIR AS ADDZTZONAL ZHSURIID: <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br /> SHOULD AK'f Of 1'1f8 AIOVE DUCRlMD poLlan U CANCELLlD IEFOM TH& IXPlM110N <br />'1'U CI'l'Y 01' SAN'l'A. ANA. DATE THEREOf', TH& I8lUIttG INSURER WILL &llDUVOR TO MAL ~ DAYS WfUnEN <br />ITS OITICBItS BMPUrlDS AGEN'1' NOTlCI!! TO THE CIItT1PJCATE HOLDER NAMED TO THI!! LEn. BUT l'AtLUft& TO DO so SHAll <br />AT'l'N: DAVID URSIN, VOLTJNTEERS AND R.EPRBSBN'l'A'l'IVZS IM'081 NO OIUQAnoH OR UA"UTY Of ANY KIND UPON THIIN8UftEft, ITS AGINT' Oft <br />20 CIVIC CBNTER, 8AN'1"A ANA, CA 92701 ft!PftESINTATlVEB. <br />AUTNOftIZED ft.'ftE8INTATWI <br />, J!.__J.~~ <br /> <br />ACORD 25 (2001/08) <br /> <br />C> ACORD CORPORATION 1888 <br />