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08/2AS/2004 10:20 <br />909-587-2995 <br />ANTHEM INSURANCE <br />PAGE e2/e3 <br />..... ........ . <br />:� A�Y.�I�yII• r <br />w ` <br />IM <br />= ' `•" •,�,;.:,...vA7H IIlODMj <br />^i <br />::A <br />w <br />06 24 04 <br />PADDLER � I I <br />THIS CEgTIFIC <br />ONLY AND C <br />TT;A IS ISSUED AS MATTER OF INFORMATION <br />NFERS NO RIGNTTB UPON THE <br />ANTE M INSURANCE SERVICES <br />CEBTIFICATE <br />42145 LYNDIE LANE SUITE 202 <br />ALTER THE C <br />ER OEI A 4 TE QED ES �T E PPOOUCIEESEtELow- <br />TEMECULA CA. 92591 <br />.. ._ COMPANIES AFFORDING CCVERAQE . .. <br />_._ <br />D°"NY <br />ASCOTTSDALE INSURANCE COMPANY <br />UNSURM <br />RELAMPAGO DEL CIELO, INC. S <br />CO NY <br />eA <br />950 WEST 17TH STREET, SUITS A <br />SANTA ANA, CA 92706 <br />cowANY— <br />c <br />COMPANY . <br />. <br />D <br />TMI3 IS TO CeRnPr THAT THE POLICIES OF IMUMNCE WITTED BELOW HAYS BEEN MUED TO THE INSURED NAMED ABOVE FOR YHE POLICY PERICO <br />INDICATED. NOTWITHSTANDPiO ANY REGUIp6MENr, TERM OR CONDITION OF ANY CONTKWT OR OTHER DOCUMlNT WITH RESPECT TO WHICH TH19 <br />CERTIFICATE MAY BE 199U1'D OR MAY PERTAIN, THE INIRIAANCC API eD BY THE POLICIES DESCRID�D HETiON 6 SUEIECT TO ALL THE TERMS• <br />O(CLUSIONG AND CONOfTIONEI OF BUCN POLICIES. LIMITS SHOWN MAY HAYr; BEEN REDUCED by PAID CLAIMS <br />TA TTl Or MMIIIAfICE MUCYNUmpm Poury Yn aTm PIDUO'EVIIIATIDY UYIn <br />DATE ""PAIn DAT%i014"w" <br />A <br />oacpAl <br />Luulux <br />eGNHMLMDMOATC <br />s 11000,0 0( <br />X <br />• <br />DOMMERCU LCENE�u LUAMUTY <br />CLIAMS MADE OCCUR <br />CLS10b0567 <br />PRODUCTS. COMr OP OGB <br />. 1 000, 00i <br />LXI <br />02/14/04 <br />02 14/05 <br />W9a rmtaAWINURY <br />s 1,000,00 <br />'NPiI'y 6 WR fRw"TORS,•HN7 <br />EACH ouguriENC <br />t 1 1fl 0 0, 0 0 t <br />rae rAE,M!ae a: rrel <br />Il? <br />s 1 b fl, 0 o t <br />AMMC44U <br />UAYAIYr <br />I <br />MEO Ew 1.%w ratD l <br />0 5,00 <br />- <br />ANY" <br />COMM40 SINGLE UN <br />S <br />ALL OWNED AUTOS <br />-'•• .. - <br />�'-'_ <br />SCIIEDULEDAUTOs <br />@pp� <br />IWf NfNKKRtRV <br />t <br />-- <br />MMD AUTOS <br />•- <br />t <br />NONVWNEDAUTOS <br />�; <br />s <br />PPOPERTY DAATABE <br />oMAaE <br />LIArYLITr <br />AUTO ONLY •EA AOGOINT <br />It <br />ANYAUYo <br />/ <br />FK,TiAWpENT <br />f <br />A DATE <br />5 <br />be <br />uw WDIUTr <br />•• <br />UMdY,IA fUR/1 <br />EACH OCCUIPINOE <br />ADOfEOATE <br />- <br />t <br />S .••. •• - <br />OTHERTHAN RELU FOMI <br />s <br />YrDYltEria 90MPlNtATfoN AND <br />EMPLof ml UAMUT• <br />DTATlICRYUMIT9 <br />THE PROP�TOFV �'� <br />EAOI AOCIDENr ! <br />PIWTNE "JMC6CUTIVE <br />PARCETSA{IE: <br />DISEASE-AOUCfUWT y <br />ENCL <br />OTlIFR '., <br />oNI$A5E-EACH EMPLOYEE a <br />DEICRo?,noN OP OPEMTIONSAACAYIORSVlMKLESJ!,"Cult rrm <br />--- <br />CERT�OLDER IS NAMED AS ADDITIONAL INSURED- *10 <br />CANCELLATION <br />-- <br />YS NOTICE OF <br />WILL BE SENT FOR NON PAYMENT OF PREMIUM <br />z <br />CITY OF SANTA ANA COMMUNITY <br />SHOULD MY OF THE ASOVEHaO IMD MUDIM YY MNG ALM BEpo" r,E <br />OJOHNT AGENCY <br />H IIIIATICMDEVI@DAM TNEHEt>!, THE MUNo ceEfPANr RILL QDEnrOR TD uKN <br />ATTN ; <br />: JOHN MALONEY <br />�, o.,b . AImA NVTrce To TDB crtolr CAT! mvu n NAa Tor a LFfi, <br />20 <br />2 0 C CRCA PLACE <br />BIR Pro LURE M MAIL SUCH NOTICE SHALL Yl"I! KO CRI N.ATIOS OR UAf lI <br />TA AN <br />SANTA RNA, CA 92701 <br />or ANY KIND UPON TNC COYPNIY• ITS AUPM 0111 RFARlYlNTATME9, <br />nuTt onnED PIPIT <br />��%��j'-.�>;i•""Ii' zbx%� .....I.a.'..u....t:.-K <br />l <br />C7 L..,T _. � _ _. Y..�.�'l.� <br />