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<br />, S~P- \4-2005 11: 01 SANTA ANA POll CE DEPT <br />r <br />FROM. : IMPERIAL INSURANCE AGENCY FAX NO. :6612902770 <br /> <br />714 245 8094 P.02 <br />Aug. 03 2005 03: 34PM PI/I <br /> <br /> <br />05I01t:Z005 <br /> <br />1'MIScsmF'JCATE. tIIUED ABA""TT'IifI of ..~noNDt&.Y ~ ClJltfERSMQ <br />RIGtfT1I "fl'()PI"" CIiJ{n,laTE t1CllDEll. THIS aJn'FICATE DOE_,.at MlDID, <br />~ OR.N.TERTJoif. t::OV9WJE"~ .y THE POlICIEI BQ.rNI. <br /> <br />INSURERS AFFORDING COVERAGE <br /> <br />INSURE!< II: PENN - S'TAR INSURANCE co. <br /> <br />IN&UeR B; <br /> <br />IIISURI!R C: <br /> <br />IIISURER D: <br /> <br />INSURER E: <br /> <br />PllOOUCl!R <br />SYSCO GE-,Il'ISU_CE!r\IC. <br />+'50 pAfU( MJSI\l <br />p,O. BOXe7M <br />C~8. CA 91372 <br />INSURED <br />JOSE TORRES AND JOSE TORRES JR. <br />29124 HIGHPLAlNE5 CT. <br />CASTAfC lOA 913~ <br /> <br /> <br />"... IS TO camfV TloCATTME PC1JCCU Of' ~ USTED I!IiUMltAVIii IeEN l5tluEDTO lltE ttsUREDNANEDHlCIIJ[ fOR l14E p()UC'Y' PE'RtOO INDtClATliD. <br />NOlWfll'dTAHDINO/IINY AEQOIROIf.NT. TEfl" ORQONDrnoNOIF""" CClNTfUlCTMOTttEPl 'QOIC\JIIIEttr WItH RESPECTTO~"JM)S ct:lmFICATE....y BE UiSUIEO OR <br />,"",y PEflTAIN. THE MUflANCI! AFfQN:)!D BY TtE POlJClES DESCfI18ED HEftel"'" &lBJECT TO H..L 1')4E TE~"". exo..USl0N'9 AND CONOmONS O~ .5\.IC.r' 1'Ol1C1ES. <br />~1O"T8 L..1W113 .IHCJWN 1M'" HAVE BEe.! RE0UC2.0 8Y plUf) Cl.AI~S. <br /> <br />IN8 <br />l TR TYPE OF INSURANCE <br /> <br />POUCT NUM810R <br /> <br />POLICY <br />EFFECTIVE <br />D <br /> <br />POl.ICY <br />EXPIRATION <br />E <br /> <br />A <br /> <br /> <br />-r-' <br /> <br />COhlMERI;1AL GENERAl \.lJ'8llftY <br />CLAIMS WlDI!C!J OCCUR <br /> <br />CPS5005928 <br /> <br />0510112005 0510112006 <br /> <br />GiN\. "CiG~EUTE LIMIT #IIPfI'l,IIE;S PE.R~ <br />l'OI.,ey[~ ,.<>- D coc <br />_ .ECT <br />AUT............ LlIlIHIlIY <br />-"",ry <br />AU. QWtI/,ED AUTOS <br /> <br />B <br /> <br />X IiiCMmU'..f.:J -.u'105 <br />r4IflHDAlIfOe <br /> <br />Of4B96860 3/21/05 3/21/06 <br /> <br />NQN.QWfIlED AUTOfi. <br /> <br /> <br />~N.ITO <br /> <br />acl!Sa lJA.BIUrt <br />OCCUR 0 CUIMS w..oE <br /> <br />DEDUCTlSl..l! <br />REl9'TION I <br />WORKERS CO~8A,nON MD <br />B'PLD"'I!"~' LlABtLITY <br /> <br />ORM <br /> <br />:0 -1'0 <br /> <br />Vt~ <br /> <br />,i. r,\t <br /> <br />-") <br />/ <br /> <br />, ,(. <br /> <br />l <br /> <br />l <br />.~: ';;h''': <br />'~'t" /\.tt0 <br />,\.i\ ; C'L_ <br /> <br />OTHf:R <br /> <br />Y','."" <br /> <br />UMITS <br /> <br />EACH OCC\JRRENCE <br />fiRE DAMAGE (My one l!te) <br />MEO. EXPENSE (Any OM po......) <br />PERSONAl & AOV. INJURY <br />GfNERAlAGOREGATE <br />PROOUCTS<OMP/OP AGG. <br /> <br />S 1,000.000 <br />100,000 <br />5.000 <br />S 1,000.000 <br />S 2000,~ <br />S 2,000,000 <br /> <br />COMBINEO SINGl..E <br />LIMIT (E.a acddeol) <br />BOOII. Y INJURY <br />(p"P""""l <br />BooIl Y INJURY <br />(Per eeQdiMJ1) <br /> <br />PROPERTY DAMAGE <br />(P.r .eeide"l) <br /> <br />:' "~"OOOI <br />s I <br /> <br />AUTO OfIIl Y . EA ACCIOENT S <br /> <br />OTHER THAN fA ACC S <br />AOTOONcY: AGe S <br /> <br />EACH OCCURRENCE <br />AOOREOATE <br /> <br />-I <br />1 <br />"l <br />--~ <br />_3 <br /> <br /> <br />S <br />S <br />S <br />S <br /> <br />.~ <br /> <br />S <br /> <br />DESCRlP'TlON OF DPE'RA11QIIlM..OCAOOHSNEHICLESJEXClU51ONS ADPI!!D illY ENDORSE_NT/SPECiAl.. PROVISIONS <br />CERTIFICATE ..OLDER IS NAMED AS AI' ADDfTlONAl INSURED WITli THE RESPECTS TO THEIR INTEREST 11'1 THE OPERATIONS OF THE <br />NAMED INSURro <br />-10 DAY NOTICE OF CANCEUATION DUE FOR NON PAYMENT OF PREMIUM. <br /> <br />CERTIFICa.TE HOLDER <br /> <br />IoDOITlONAlIN6U'fIED; lI\I!ll.IRl!JllETTER A CANCf.LL..ATtoN <br /> <br />Cily Of Santa Ana <br />police dept. /M-97 <br />PO BOX 1981 <br />Santa ~na, CA 92702 <br /> <br />lIP'IoULD IIH't OF THE ABOVE OE~CJIUCJt() PCJ..Gll!S IE! (;AtCEu.l!D <br />f1Ef'~ THIi ~ltAflO"DA1E T'HERliOF. THIIE, 1&SlJING NVRER <br />Wh.l EfC)EA.'IIOR TO """"" 30 a.alS WRmEN NOTlCfl TO THe <br />CERTIFJCATI!.l1OlDER ~ED TO '!"ME ~.lIuT 'AIlUI'I:e TO 00 60 eMNJ.I"POSENO <br />OBlIGATION OR l..I,t,II\.ffY 01' Nf't IOND UPOI'l THE 1N8Uf'iR, ,n .AGI;:NT'!i OR <br />Al!l"fUi,SE:IIIT~lM9 <br />.UTl+OA~ A!PRESE <br /> <br />~- <br /> <br />~. <br /> <br />'J'.,,..- <br /> <br />