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10/14/2005 10:09:56 AM Sara Coutee <br />Page 4 <br />ACURQ CERTIFICATE OF LIABILITY INSURANCE OF ID SA DATE IMD°/YYTYI <br />FAZE--1 1071 4 05 <br />PRODUCER <br />G. S. Levine Insurance <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Services, Inc. <br />10505 Sorrento Valley Rd. 8200 <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />San Diego CA 92121 <br />1 <br />Phone: 858-481-8692 Fax: 858-481-7953 <br />(INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />iNSLIPEFo- Greenwich Insurance <br />22322 <br />FEE e <br />Scott Fazekas & Associates_ <br />9 Corporate Park S-200 <br />Irvine CA 92714 <br />wsueERD <br />_. <br />IN5UPER E <br />'V YCRMV CJ <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 />LTR NBRD TYPE OF INSURANCE POLICY NUMBER HOT <br />POUCY EFFECTIVE - POLICY EXPIRATION <br />DATE MMNDiTY DATE IMMUDDI LIMITS <br />GENERAL LWBILRY <br />FACH Fii tuRRENt.F $ <br />_iLMMEPLIAL GENERAL LAEILRv <br />NEMISES Ee.1,11IUt, <br />l <br />tR <br />LAIMeMAIJL uUC_UR <br />Ei <br />MED P (Any bnp Vel%On( <br />PEPSDNALNADVINILIRv <br />¢ <br />�ENEPAL AL.CREI ATE <br />3 <br />PPi'OUnT, IIWILD AII 8 <br />LEN'L AGGREGATE LIMIT APPLIES PER <br />POLIC, JPECRO- <br />T lllC <br />AUTOMOBILE <br />LIABILITY <br />I:ED NGLt LIMIT f <br />-NY 11111 <br />(ET,dC�ItlPntlMTISHI <br />AL, I MMED At IHN <br />B JCILY IN.III1 f <br />It HER (LID MITI I', <br />IVP! (e,onl <br />HIRED AUTOS <br />BDDILYIN.ILIRL <br />g <br />Nf_N DATIED At TFIS <br />(PI, "IITFID <br />VRDPEPT'i DAMAGE <br />f <br />-- <br />IT, arrl0en[I <br />CAIU6E <br />_At <br />LIABILITY <br />I VDNLY-FYAitWINI <br />$ <br />AN'I N HIP <br />EAArq <br />— <br />f <br />,THEP THAN <br />3 <br />A�IT_i CHL" Z' <br />EXOESEUMBRELLA LIABILITY <br />EA[H I)CLUFPEN,E <br />g <br />A[1t .PEtiATE <br />$ <br />CI[UIP El CWMSMADC <br />f <br />DID It <br />E <br />$ <br />WORKERS COMPENSATION AND <br />Yvc ATL Dr <br />EMPLOYERS' LIABILITY <br />TORY LUTMIITS EF <br />EL LAGH A,LIDCNT y <br />AN• PPIIPMETVPNARTNER(ENCCUTIYE <br />OFFICER/MEMBER EYJ_U= <br />ELDISbV'E EAEMPLOYFE <br />- <br />L <br />I(ypl, Dell(IbE unEPl <br />EL. DISEASE -POUT': LIMIT <br />f <br />1'. <br />OTHER <br />rAJSFESIALPF(JV131,-ISt <br />Professional <br />DPR9411612 <br />06/05/05 <br />06/05/06 <br />Claim/Agg 1,000,000 <br />Liability <br />Ded 10,000 <br />DESCRIPTION OF OPERATIONS / LOMTIONB / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT ( SPECIAL PROVISIONS <br />Re: All Operations <br />Proof of Insurance <br />*10 day notice of Cancellation applies for non payment of premium. XX <br />Laurz Mitt SLcedy <br />City of Santa Ana <br />Planning & Building Agency <br />20 Civic Center Plaza (M-20) <br />PO Box 1988 <br />Santa Ana CA 92702 <br />CITSAN_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WIL�MML 30* DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT�IYEyrYYyBBIEEEy <br />