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<br />Page 1 of1 <br /> <br />. <br /> <br />6/19/2007 2:08 PM FROM: Fax Municipality In5u~ance Services, Inc. TO: 1-951-685-3630 PAGE: 001 OF 001 <br />. ' <br /> <br />Certificate of Insurance <br />Sparta Program <br /> <br />fJ - /OV&>- ;2IS <br />A - .20 OJ - J9'O <br />A - .;1.004 - ;).11. <br />A -.t~ - ~IS- <br />AM 9: 12 <br /> <br />Name Insured: <br /> <br />Adlerho"t International, Inc. <br />3951 Vernon Ave <br />Rive"ide, CA 92509 <br /> <br />Named Additional Insured: <br />SANTAANA(SPAR7IlIJ JUt -6 <br />20 Civic Center Plaza '}\'Q Box 1988 <br />SantaAnaCA 92701 TY (,: <br />CI ." <br />CLEF' <br /> <br />T!\ AN" <br />'~!jNCll <br /> <br />I':;' <br />:::> <br />'"...1 <br />""': <br />"- <br />'::!' <br />..., <br />i:'j <br />.-; <br />r- <br />o <br />"- <br />N <br />N <br />" <br />'J:I <br />o <br /> <br />Certificate /I <br /> <br />Coverage <br /> <br />Limits <br /> <br />Deductibles <br /> <br />Terms & <br />Conditions <br /> <br />Extlusions <br /> <br />SSA06-0039 <br /> <br />SPARTA INSURANCE PROGRAM: Commercial General Liability - Hazard 1 <br />Contract Value: $16,000.00 <br />Coverage Period: 7/612007 to 7/6/2008 <br />Insurance Carrier: Essex Insurance Company <br />Master Policy: 3CV8902 <br />Master Policy Effective Date: 11/1512006 to expiration <br /> <br />$2,000,000 General Aggregate / $1,000,000 Each occurrence / $1,000,000 Products/Completed operations / <br />$1,000,000 Per>onal & Advertising Injwy1$50,000 Fire Damage / Medical Payments Excluded <br /> <br />$500 BI &. PD Per Claimant Including Loss Adjustment Expense <br /> <br />$750.00 Premium (Fully Earned) <br />$23.81 Taxes (Fully Earned) <br />$75.00 Certificate Fee (Fully Earned) <br /> <br />$848.81 Total Amount <br /> <br />1 No Cancellations Allowed. Premium. taxes and fees are fully earned at inception. <br />2. Operations and Rating Based: Training K-9 & police office" on city property (No public exposure) <br />3. Department: Santa Ana Police Department <br />4. Additional Insured(s): Not Applicable <br />5. No Professional Liability Coverage provided. <br />6. NO PUBLIC EXPOSURE WORKING WJTHIN THE CITY OF LOS ANGELES DEPARTMENTS AND THEIR <br />EMPLOYEES ONLY <br />7. TIllS POLICY DOES NOT PROVIDE COVERAGE FOR ANIMAL MORTALITY OR ANIMAL BITES. <br /> <br />Asbestos, Assault &. Battery, Employer Related Practices, Subsidence, Independent Contractors, Pollution, Cross Suit, <br />Lead or Silica Dus~ Mold or Bic-organic Growth or Mildew, Punitive Damages, Animal, Breach of Contrac~ Y2K <br />Electronic Data, Medical Payments, War or Terrorism. <br />The insurance provided under this policy is limited to your work performed on behalf of the entity named as <br />"Additional Named Insured" above and doesn't extend itself to any other work performed by you or your orgaruzation. <br />Coverage is limited to the description of operations and rating bases listed in "Terms & Conditions" item 2. <br /> <br />Per the Master poli, .f; a copy is available by written request to: Municipality Insurance Services, Inc.. 302 W. Cerritos <br />Ave., Building #7. \naheim, CA 92805 <br /> <br />^; ~?J)VL..) A~., <br /> <br />,~.,~ ~:\j <br /> <br />6~#~~~,~ <br /> <br />Carol Frost / President <br />Municipality Insurance Semces. Inc. <br /> <br />\65 <br /> <br />I <br /> <br />/,.,>.>l.,>L,-,.;l ,--ol) <br /> <br />'1.llUL1(;Y <br /> <br />302 W. Cerritos Ave Bldg#7 Anaheim, CA 92805 (800) 420-0555 (714) 687-1100 fax (714) 687-1106 LicensesCAOC04849; ORI95423 <br />Website address www.2sparta.com <br />