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SENT BY: LAKE INSURANCE AGENCY; 7148387568; SEP-17-04 8:39PN; PAGE 2/3 <br />ACORD CERTIFICATE OF LIABILITY INSURANCE I .1F, "'DDN""n <br />___...__-._-_._����.- ii .......�nvrm E,wN <br />L <br />e Insurance Agency O11LY ANDCONFERa NO RIGHTS UPON TILECER3891 Newport Ave., Suite 28s HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POMIES BELOWic #0747473 <br />ustin. CA 92780 INSURERS AFFORDING COVERAGE NAIC I <br />208 North Broadway <br />Santa Ana, CA 92701 <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN UFD T <br />ANY REQUIREMENT, TERM OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE IBBUEO OR <br />MAY PERTAIN, U 7HE INSURED NAMED ABOVE FOR THE POLICY PERIOD 1 TED. NOTWI TANUNNG <br />THE INSURANCE CONDITION OF ANY CONTRACT OR AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGR@ T@ LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD (LAMS. <br />LTR <br />TYPE OF NNMWMCE <br />POLWY Roam <br />Tz <br />LM�m <br />A <br />o�R"LLIAmUTM <br />X <br />COMMERCIAL GENERAL LNBLRY <br />CLAIMS MADE OCCUR <br />SCP0S18504 <br />08/02/2004 <br />011/02/2005 <br />.A..,. <br />f 1,000,000 <br />MEUFJ�WI(M,IIT�OneupenAn) <br />so 000 <br />f <br />PERSONAL v upv <br />f 1 ON' <br />GFNLAGGREGATE LMIT APPLIES PER: <br />X POLICY lAL <br />GENERAL AOGREMTE <br />f 2 000 <br />PRODUCTS- AGO <br />t Includik <br />AUTOMWLX <br />LWE.TTY <br />MY AUTO <br />ALL OWNED AUTO <br />SC OULEDAUIDS <br />AIRED AUTOS <br />NON•OYMED AU <br />CCOWWMOE DANGLE LAST <br />_ <br />: <br />BOOLY INJURY <br />(P.P.) <br />f <br />91 HAIRY <br />IFW m=d") <br />f <br />1PRCZM DAUAOt: <br />_ <br />GARAGE LIAIRYry <br />ANY AUTO <br />IXCE66KMIBRELLA LIAmLITY <br />OCCUR Q CLAIM MADE <br />DO ICDSXS <br />RETFNTON <br />*O XERS CONPON ATION AM <br />EMPLOYERY LIABLNYAW <br />OFF MBEER EXCLUDED? UTNE <br />Imtl.seibw.ndr <br />AL PAONSIONS blow <br />/ <br />AUTOONLY-EA ACCIDENT <br />f <br />OTHER T' N ACC <br />Aura DNLv: wcG <br />EACH OCCURRENCE <br />S <br />f <br />f <br />AGGREGATE <br />_ <br />S <br />LR <br />WRS ERS.L. <br />f <br />EACH ACCI <br />f <br />E.L. DSEASE-EA EMIPL0 <br />f <br />e.1- DISEASE -POLICY UMn f <br />itional insured as per exhibit B attached <br />Subject to 10 days notice of cancellation for non-payment of premium, <br />CERTIFICATE HOLDER rwAV.C.. ....... <br />THE CITY OF SANTA ANA <br />Community Development Agency <br />Attn: Carla Tompkins <br />PO BOX 1982 <br />Santa Ana, CA 92702 <br />EXPIRATION QATI THEREOF, TINE nMImG INSURER WILL I00DWW MAC <br />DAYS wMrrmN NOTICE To no CaRIIFII HOLOG MAMm TO no LEFT, <br />CORPORATION JBBB <br />/14u <br />