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145/28/2005 11:22 7142509029 ALL SIGNS AMERICA PAGE 02 <br />p-20D$-►AA <br />SENTRY INSURANCE A MUTUAL COMPANY <br />STEVENS POINT, WISCONSIN <br />to PARTICIPATING MUTUAL COMPANY) <br />A MEMBER OF THE SENTRY FAMILY OF INSURANCE COMPANIES <br />CERTIFICATE OF IhSURANCE ACCCUNT NUMBER L9-39070 <br />This certificate is issued as ■ matter of information only and confers no <br />rights upon the certificate holder, This certificate does not amend, extend <br />ur alter the coverage afforded by the policies below - <br />Name and Address of Nome and Address <br />Ce,-tlficate Holder of the Insured <br />THE CITY OF SANTA ANA K t A ENTERPRISES INC ❑BA <br />ITS OFFICERS, EMPLOYEES, ALL SIGNS AMERICA <br />AGENTS, VOLUNTEERS d 15481 RECHILL AVE STE AEB <br />REESPRESENTATIVES TUSTIN, CA 92780 <br />20 CIVIC CENTER PLZ <br />SANTA ANA, CA 92701 <br />This certificate is issued on 09-23-2005 and is effective until 09-2'-2006. <br />It certifies that pollcies of insurance listed below haws boon Issued to <br />the insured named above, Notwithstanding any requirement, term or <br />condi'ti:pn of Any contract or other document with respect to which this <br />certificate may De issued or may pertain, the insurance afforded by the <br />Policies described heroin is subject to all the terms, exclusions, and <br />conditions of such policies. Limits shown way haws been reduced by Paid <br />claims. <br />Coverage Provided Policy Number <br />All Limits in Thousands <br />Buslnessowners Liability 49-59070-01 <br />Each Occurrence <br />i <br />Soo <br />Medical. Expense <br />0 <br />IC <br />Includes: Bodily Injury <br />Damage to Premises <br />a <br />250 <br />Property Damage <br />General Aggregate <br />0 <br />1,500 <br />Personal Injury <br />Products Aggregate <br />8 <br />1,500 <br />Advmrti33np Injury <br />Hired and Non- wned <br />Workers' Compensation and <br />Employer's Liability <br />Umbrella Liability <br />Dues Not Include: <br />-Pers/Adv Injury <br />80-CIO35 (SFA) <br />ALL 49-39070 31 <br />10-2a--2005 <br />PAGE 1 <br />(oogn <br />49-39070-02 Statutory <br />Each Accident <br />a <br />Soo <br />Each Disease/Employee <br />a <br />500 <br />Each Disease/Policy <br />5 <br />500 <br />49-39070-03 Each Occurrence <br />7 <br />11000 <br />General Aggragate <br />a <br />1,000 <br />Products Aggregate <br />0 <br />11000 <br />APPROVI 13 AS Tb FORM <br />;,aura Stitt S dy <br />��_,a�slant City ttorney <br />