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<br />ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MWDDrfYYYl <br />04121105 <br />""OOUClR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATlON <br />UGI Long Beach ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />110LOER. TI1IS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />29A Technology Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Irvine, CA 92618 <br />S4S 7SD"9200 INSURERS AFFORDING COVERAGE (\tAlC. <br />INSURE!) IIItSUA~R."" Mercury Insurance Campan 10900 <br /> OSTS, Inc. INFoUAI::R e Preferred E mployer9 Insurance Co. <br /> 3333 Brea Canyon Road, .101 1I4S\Jf\Ef\C Underwriters at Lloyd., London <br /> Diamond Bar, CA 91765 II\lSuAER c: <br /> 1!\I1;;\JHt:Hl::. <br /> <br />Client.. 46574 <br /> <br />OSTS <br /> <br />COVERAGES <br /> <br /> THE PDLlCli:S OF INSURANCE USTED BELOW HAVE BEeN ISSUED TO THE INSURED NAMED "eoVE FOR THE PDLlCY PERIOD INOICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM 0'" CONOITION 0.. p.,.,v CONT"ACT 0" OTHER OOCUMENT WITH Rf;3PC=CT TO WI IjOI I TIII~ ocnTlrlCATC MAV oe 1&&lJEO OR <br /> M.AY PER-rAIN, THE INSURANCE AFFORCED BY THE POLICIES OESCRIBEO HeREIN IS SUBJECT' TO ALL THE TERMS, E.XCl.USIONS ANO CONOITIOr-tS OF 6UCH <br /> ?Ol..lClI:S. AGGReGATE LIMITS SHOWN MAY' HAVE BEEN REDUCED BY PAID CLAINlS <br />~ PO.~~Y EFFECTIVE "g~'i: I~~:~~N LIMITS. <br />\.T" T......,n.,'NAII..Nr.1C' I'nllr....NIIIlII"'FII MIICI ...... <br />A ~NiEflAl U"Pll.ITY CCPOO14536 04117105 04117106 E~CH OCCU~ReNCE .1000000 <br /> X COMMERCIAL GENEFML LI^BlllTV DAMAGE TO RF.NT~O . <br /> - ~ \A.AIM:S MIllUt:. ~ v.,.t.Vt1 MEC EI'(P (....n)' 0''<' P"'.Of'/ 1.5000 <br /> PERSON"'''''' AO\! INJUR"l' '1 000 000 <br />I QENF.FlAI, AGGREGATE $2 000 000 <br />, ~'~AGO~~n t~IT ArlS ~E~ PAODU~TS.COMPKW^GG . <br /> POlICV ~~.; LCC <br /> .!!!TOMOBU. UIotm.rT"'t COU81"IEC\ 9'",""1.E 1I.~IT . <br /> (el aCCIdent) <br />.. - ANY AlJfO AOTIlOllV ^y ,) 1UP.1S~~SV <br /> - AhOWNECM.JTQS {pooqsfll, BODIL V INJUFlY <br /> 1<'; t~lll~~T lPelp~rl(lnJ . <br /> - 301IEOU1.C'D AUTO:) T\7(- ..7 <br /> - l1lftEO"'UlDfl 21/ ./7r l~f" SOoll...V INJURV <br /> . <br /> NON. OWNED AUTOS (PCr3CeI(jO"IJ <br />-. - S' ~V <br /> W~O.:I 01- (FI^O~d PROP~A'TY oAMAQf. $ <br /> (F'f1'acckla"t) <br /> -=r~G' ~'.ILITY ,,[)TO 01'0'1. v . fA ACCIDENT . <br /> AI'Il'fA\JfO OT\olEf;!TI1AN fA ACe S <br /> AUTO ONLY: .00 . <br />'A ::!J~S:~/UU..'ELI.A L1AIIIIUTV CUPOOOll14 041'17/0'" 04117106 E"'CHOCC'IAtl.t:Nt"E .< "^" 000 <br /> X OCCUR 0 Cl....jM$ MAo~ AQOFlE'OATE .1 000 000 <br /> . <br /> ==J ~.ouc u"" . <br /> A.ET~N1'ION . . <br />B w'Ofllt:EA6 COY'IENGATlON AND WKN1057455 04117105 04117106 X I we STATU', I ICJ~' <br /> t;MI'LUrtH:!i' L1ADILlI T E L EACN ACCIOeNT .1 000 UW <br /> ANV PROPRIETOR/PARTNEAlEXECUTlvE <br /> or:l=lCERlMEMSfA C:XCI.VDED? to L OlSC:"SE. Ell. EMPLOYEE .1000 000 <br /> la~~I~I~r~~~~"" . ~,1.. DISEASE. POlIC'{ IMIT .1 aoo aoa <br />C OT~Efl Prot Uab. MIBZ04D40004 08131104 08/31105 $1,000,000 <br /> Ded: 51D,OOO <br />DESC'AlP'nON 01' op&:"..noJrrrfS I LOCA"ONS , V6HK:LES I fi;_C1.U.lI1ON9 .baED .'1 ENDO"GI!VENT I SPEaAL lII"o.,.aION& <br />.10 Day notlc. applies for nonpayment of premium. Certificate Holder, It's <br />oftlcCl"3, agent:) and employeeG .:Jre o:unod .. ^ddlllonallneurod par tho <br />attached endorsement with respecllo 811 operallon. by the named Insured. <br /> <br />: CERllFICATe HOLDER <br /> <br />CANCElLATION <br /> <br /> ~"'nll1 h 1I~'f' nit"..... Allnvp nF~III"F." POLICIES BE' CANCELLI'D BEFOAf: THE EXPl~AT1ON <br />City 01 Santa Ana gAlE TIiER~OF, rHE ISSUING IN5URIA WILL ~.U.M"'IL ~ DAYS WRITTeN <br />P_O. Box 1988 NOTICE TO THI! CERTlFlCATIE HOLPIiA N^MED TO THiE LE".lIIO"'~ v - INIUe <br />Santa Ana, CA gno. ....K..~......N~~__A~~...~..~....~~ "xx <br />, <br /> "UT~OAll~ REPAf.SENTA TIVE <br /> ~~~...- <br /> <br />IACORO 25 (2001,..,8) 1 of 2 <br />, <br /> <br />_M281442 <br /> <br />CXEJC <br /> <br />~ ACORD CORPORATlON 1995 <br />