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<br />'. <br /> <br />. <br /> <br /> <br />OF LIABILITY INSURANC' <br /> <br />RHV -~;;;---i <br />UODC 01-07-2005 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMAl ION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> <br />INSURERS AFFORDING COVERAGE <br /> <br />/!CDBD,. CERTIFICA <br /> <br />PRODUCER <br /> <br />USAA INSURANCE AGENCY, <br />812846 P:(888)242-1430 <br />P. O. BOX 33015 <br />SAN ANTONIO TX 78265 <br /> <br />INC/PHS <br />F: (877)905-0457 <br /> <br />INSURflJ <br /> <br />INSUR~R A: Hartford Casual t <br /> <br />---- <br /> <br />Ins Co <br /> <br />WILLIAM & BELINDA BELISLE DBA ~E~LE <br /> <br />& ASSOCIATES ~ ~L{ ./~ j.. <br /> <br />PO BOX 5252 / OV" <br /> <br />W GARDEN GROVE CA 2846 <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABCVE FQq THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W!TH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE PO:...ICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITlm/S OF SUCH <br />POliCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> <br />INSR TYPE OF INSURANCE POl/CV MJM8ER POlffY£fffCTN£ POUCY EXftRATION <br /> <br />INSURER B. <br />INSURERC: <br /> <br />INSURER Q. <br /> <br />INSURER E: <br /> <br />"MITS <br /> <br />GENERAL LIA8IL"Y I <br />A ~-i COMMERCIAL GENERAL lIAB!UTY ! 65 <br />CLAIMS MADE [K] OCCUR! <br />X Business Liab <br /> <br />>- <br />: OEN'L AGGREGATE LIMIT APPliES PER: <br />PRO. X ~OC <br />AIJTOMOBlLE LlA8IlffY <br /> <br />, PERSCNAL & AOV INJURY <br />~ <br />GENERAL AGGREGATE <br /> <br />Û,OOO,OOO <br />,300 000 <br />,10 000 <br />i,l,OOO,ooo <br />,2 000 000 <br />.2 000 000 <br /> <br />EACH OCCURRENCE <br /> <br />SBM FM8438 <br /> <br />09/01/04 09/01/05 <br /> <br />~IRE DAMAGE (Anyone 'Ire) <br />MEDEXP(Anyo''''pllrson) <br /> <br /> <br />PRODUCTS. COlI.4'tOP AGG <br /> <br />ANY AUTO <br />'~ AlL OWt~EO AUTOS <br />¡ SCHEDULED AUTOS <br />I HIRED AUTOS <br /> <br />8NON:~Nm Aum, <br /> <br />I~AGf UABtlfTY <br />rl ANY AUTO <br /> <br />COMBINED SINGLE UMIT <br />(Ea ilcddðll1) <br /> <br />, <br />, <br />, <br /> <br />I BODilY INJURY <br />(P~I persorÜ <br /> <br />=t-----------i <br /> <br />! <br /> <br />---+..-------.--- <br /> <br />BODilY INJURY <br />I (P~r ~ccjclem) <br />; PROPERTY DAMAGE <br />(f>~r ~e<::idem¡ <br /> <br />i <br />, <br /> <br />-----.-.--- <br /> <br />AUTO ONLY. EA ACCIDENT <br /> <br />OTHER THAN <br />AUTO ONLY <br /> <br />EAAce $ <br />AGG $ <br /> <br />EXCESS LIABILITY <br />OeCUR D CLAIMS MADE <br /> <br /> <br />i <br />, <br />rORM <br /> <br />1/1/1 <br /> <br />EACH OCCURRENCE <br />I AGGREGATE <br /> <br />, <br />-¡, <br /> <br />~- <br />r ! DEDUCTIBLE <br />I RETENTION <br />WORKERS COMPENSA TJON AN/) <br />EMPlOVERS'lIA8IL"¥ <br />, <br /> <br />we STATU- <br />.1JMI <br />E.l. EACH ACCIDENT <br />E.l. DISEASE EA EMPlOYEE I ~ <br />EL DISEASE. POLICY LIMIT : ~ <br /> <br /> <br />OTHER <br /> <br />--- j -. -- <br />DESCRIFTlON OF OFERATlDNSlLOCATIONS/VEHlCLES/EXClUSJONS ADDED 8 Y EMJORSEMElVTISPEClAL PRQVISIONS <br /> <br />I <br /> <br />Coverage is Primary & Non-Contributory <br />Form S80008, attached to this policy. <br /> <br />per the Business Liability Coverage <br /> <br />CERTIFICATE HOLDCR <br /> <br />ADDITfDNAIINSURED.: fNSURERlETTEFt <br /> <br />CANCELLATION <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POliCIES BE CANCELLED BEFORE: : H~ I <br />EXPIRATION DATE fHEREOF, THE ISSUING INS:.JRER WILL ENDEAVOR T.] MAil <br />30 DAYS WRI~TEN NOTICE (10 DAYS FOR NON-PAYMENT) fa THE CERTIFICATE <br />¡"';OLDER NAMED TO THE lEFT, BUT FAILURE fa DO so SHALL IMPOSE NO I <br />OBLIGATION D.A LIABILITY OF ANY KIND UPON THE INSURER, ¡rs AGENTS 0"-1 <br />REPRESENT A TlVES. <br /> <br />RRQEPflESENT~ <br />I ~ ".,..\,-,,- <br /> <br />~ ACORD CORPORATION 1988 <br /> <br />City of Santa Ana <br />Attn: Jim Stikeleather <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br /> <br />ACORD 25-S (7/971 <br />