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CERTIFICATE OF LIABILITY INSURANCE °ATE�M/2006 Y <br />rM. 01/25/005 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />.FITNESS AND WELLNESS INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />380 STEVENS AVENUE, SUITE 206 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />SOLANA BEACH CA 92075 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED (� <br />JORGE A. HIGUERA <br />INSURER A: Zurich American Insurance Company <br />C/O KARATE DO OKINAWA <br />INSURER B: <br />501 N COMMONWEALTH AVE. <br />INSURER C: <br />4 <br />IN D: <br />FULLERTON CA 92831 <br />rnvvonr_cc <br />INSURER E: <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />ADD-1 <br />INSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTNE <br />GATE MWD <br />POLICY EXPIRATION <br />GATE MM/OO <br />LIMITS <br />A <br />GENERAL <br />LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE OCCUR <br />EOL9012327-00 <br />10/11/04 <br />10/11/05 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />X <br />T1W E TO RENTED <br />PREMISES (Ea xevenae) <br />g 100,000 <br />MED. EXP (Any one person) <br />$ 2,5DD <br />PERSONAL It ADV INJURY <br />is 1,000,000 <br />GENERALAGGREGATE <br />$ 3 000 000 <br />FIEN'L AGGREGATE LIMIT APPLIES PER:PRODUCTS-COMP/OP <br />POLICY JECT LOC <br />AGG. <br />$ 3,900,000PRO- <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOS <br />AUTOS <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />ED SINGLE LIMIT <br />ent) <br />$ <br />O(Ed <br />NJURYSCHEDULED <br />on) <br />$ <br />NJURYdent) <br />$ <br />TY DAMAGE <br />ent) <br />$ <br />GARAGE LIABILITY <br />ANY AUTO <br />A L�T�F� <br />ilPPRO <br />sss <br />1_T <br />L� �S lO <br />r_ RM <br />1 � <br />AUTO ONLYACCIDENT <br />$ <br />OTHER THAN EA AlC <br />AUTO ONLY: AGO <br />$ <br />$ <br />EXCE$$I UMBRELLA LIABILITY <br />OCCUR El CLAIMS MADE <br />DEDUCTIBLE <br />RETENT70N $ <br />L.- <br />Ass <br />/_/ <br />ACC <br />ey <br />EACH OCCURRENCE <br />g <br />aura Stitt S teed <br />sta.nt City AtLOr <br />AGGREGATE <br />g <br />$ <br />WORKERRVLIABILITY NAND <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOWPARTNER/E%ECIRNE <br />OFIRCER/MEMBER EXCLUDED? <br />:yea, do-odbe comer <br />sPECUL PROVISWNS below <br />VJc srAm OTHER <br />TORY UMOS <br />E.L. EACH ACCIDENT <br />g <br />CL DISEASE -FA FMPI_OYEE <br />$ <br />E. L. DISEASE ROUCY LIMIT <br />$ <br />OTHER: <br />7 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br />CERTIFICATE HOLDER ADDED AS ADDITIONAL INSURED ONLY AS THEIR INTERESTS MAY APPEAR. <br />CERTIFICATE HOLDER: THE CITY OF SANTA ANA, AND THE CITY OF SANTA ANNA, LOCATED AT 20 CIVIC CENTER PLAZA, SANTA ANA, <br />CALIFORNIA 92701; AND THEIR RESPECTIVE OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS, AND REPRESENTATIVES. <br />CERTIFICATE HOLDER ......_..._._.. <br />The City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana CA 92701 <br />Attention: <br />ACnon oc nnn•m:, <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL MAIL 30 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. <br />7� <br />E. Frick, CEO <br />9 ACORD CORPORATION 1988 <br />