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FROM CORRECTIONRL MANAGED CARE MEDICRL CORP. (TUE)NOV 30 2004 9:36~ST. 9:36~NO.6358an9R9R P ~ <br />COR <br />CERTIFICATE OF LIABILITY INSURANCE <br />a" io Yos oa <br />_ <br />c <br />PROPUCEA H C IFI IS 1 ED AS A M TTE OF 1 ORMA N7 <br /> ONLY AND CONFERS NO RK#ITS UPON THE CERTIFICATE <br />EIGi Zasuraaca 8arricas HOLDER. THI$ CERTIFICATE DOE$ NOT AMEND <br />EXTEND OR <br />23241 Bout3 Pointe Drive , <br />ALTER 7HE COVERAGE AFFORDED BY THE POLICIES BEL <br />Laguna Hills G 92653 <br />Phoaa:969-460-8730 Paz:9a9-460-8733 INSURERSAFFORdNC:COVERAGE NAIL/ <br />asuReD NsugEaA st. Plax Eiq i wne. xd.. w ~~ <br />~7YC~3.~K Cpra N&1RER B: '141a BtatQ r11~ <br />I~dLOai <br />~ N9lMERC <br />...,_. .... ._.....__ <br />~j ~r~y <br />si G 92$05 _ <br />1 N81YIEfI O' _.. <br /> . <br />NaEIEa E: <br />L6TED BELOW H1NE <br />1 <br />A <br />A <br />06/01/04 <br />~O THE lJBURED NAMED ABOVE FOR THE POIq <br />OTHER DOCUMENT W RH RESPECT TO W HICK <br />REED HEREN I$ SUBJECT TO ALL THE TERMIS, <br />BV PAQ CIABIS. <br />MEacw. GENERAI. LMBIIIY I HR01772007 <br />cinMa NADE XQ occua <br />AurosoNLB u.NUrr <br />ANTAUm <br />ALL owNFtAUros <br />scNa:ouLlD Aaros <br />X HIRED AUTO! <br />Y NDN-0WNEC AURb <br />Lac <br />WS UABWTT <br />ANT Aura <br />Essarsglw Lurm <br />accua ~ cwES a"DE <br />DEnuCIe:E <br />YYORYEp CDYPENBATIDN AYD <br />H laPLOTlp' WELRT <br />OFF E~RMEMIER EXC~LWED9¢CU:NE <br />8X01772007 <br />8X01772007 <br />06/01/04 <br />06/01/Oa <br />EACHaccuaaEHCE s 1000 <br />06/OS/D5 Par,AE~ ~.m s 1000 <br />viD EJn ullerall. P..an: MsooD <br />PEasoN"LEAavwuev E 1000000 <br />aEraRALAOCN:ecnre S 2000000 <br />Paoauols-CDIIWIOYAGG E 2000000 <br />(FeC rider ISNN.E LYIf <br />~ ~ESium` <br />06/01/05 aoo~rNAIaT <br />06/01/05 ~°f°0d°YSl <br />PRaPFR1VDAM~aE <br />~r~cclENlp <br />oTEJenuN EAACC <br />µ:fpaMlr, AOG <br />EAa, occwAENce <br />AaaaEw~E <br />1a9oa53-oa ~ 07/o1/Da ~ 07/D1/os ~e~eAC~IACCnENr <br />:zooooo0 <br />~- <br />s <br />7 <br />0 <br />s <br />s <br />s <br />s <br />s <br />s <br />as~s~-E.. t <br />dBEABE-POLICVUNR : <br />*10 Daya Notate of Canoallation for Hon-PayaaaL of Praoi~. Csrti.fioatJs <br />Holder is aafad as an additional anavrad par the term anfl conditions of the <br />policy (azcluding the ltorkors Ccopensatioa Policy), <br />City of Banta Ana <br />Banta Ana City Jail <br />]Lttn:Chria Laugaoaur,Contraots <br />62 Civic Canter Pla:a <br />Banta Ana CA 927D2 <br />BT.aHX00 aYAgnANraPTIeABOVeDIacq.ao-aursaBCAYOaL®Eenge7YEexwunp <br />WTE TYlgBOP, TH! aNIMD ulEUglR asJ, lYOUVOR +o auL 3G wTS agIYTEY <br />YOIICE'1'O TIE CER7INC"iE MOI.OEq WYla TO7N! LIFT, WT P"IWq! TD DO EO EMALL <br />IsFaaelo DY{AAIYIY oR LuuYUn OP AYT Rao uroN THE aEYgEq, m ADEYre oq <br />