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ADD CERTIFICATE OF LIABILITY INSURANCE OP ID RL DAn MINDD(YrYYI <br />Fa7.F.K-1 n9 27 n6 <br />PR. S. <br />G. S. Levine Insurance <br />Services, Inc. <br />10505 Sorrento Valley Rd. #200 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />San Diego CA 92121 <br />Phone: 858-481-8692 Fax: 858-481-7953 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED EI � <br />/} <br />INSURERA M P1lity and Guaranty ICE. Co. <br />INSURER B. gapleyaCE Flca Ia Encano. Co. <br />ZU648 <br />���/\ )�L �) <br />Scott Fazekas L Associates A—J' �V <br />17777 Del Paso Drive <br />Poway CA 92064 <br />INSURER C <br />INSURER D. <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 <br />XERD <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />FOUR EFFECTIVE <br />DATE MMIDO/YY <br />POUOY EXPIRATION <br />DATE IMMRDONYI <br />UMRR <br />OEXERU. UABIUY <br />EACH OCCURRENCE <br />$1,000, 000 <br />A <br />X COMMERCIAL GENERA LABILITY <br />BK02187585 <br />06/05/06 <br />06/05/07 <br />PREMISES(E¢0[[wen[e) <br />s 300,000 <br />C-MUS MADE OCCUR <br />MEO EW(".'e pomr) <br />$10,000 <br />X BFPD <br />PERSONAL BAnvlwugv <br />E 1,000,000 <br />a`TC <br />F 2,000,000 <br />GEN'L AGGREGATE LIMB APPLIES PER'. <br />PRODUCTSOCOMWOPAGG <br />s 2,000,000 <br />POLICY PER. <br />ECT WC <br />Ben. <br />1,000,000 <br />AUTOMOBILE <br />LASIYry <br />A <br />ARv auto <br />BK02187585 <br />06/05/06 <br />06/05/07 <br />B¢re0 Pirro= UM17 <br />(ER Rmbent) <br />s1, 000,000 <br />ALLOWNEDAUTOS <br />BODILY INJURY <br />$ <br />SCHEDULED AUTOS <br />(Pe, person) <br />X <br />HIREDNUTOS <br />X <br />NGNGVMEDAUTGS <br />SODLY INJURY <br />t <br />(Per R"ReT, <br />PROPERTY DAMAGE <br />$ <br />mr onD <br />ONGDE LIABILITY <br />AUTO ONLY-EAACCIDENT <br />$ <br />MY AUTO <br />OTHER THAN F+'"CC <br />$ <br />t <br />AUTO <br />TO ONLYON_Y. pCC <br />E%CEBWUMonE WBILJTY <br />EACH OCCURRENCE <br />q <br />OCCUR ❑ C(NMSMADE <br />AGGREGATE <br />g <br />DEDUCTIBLE <br />E <br />RETENTION S <br />$ <br />WOMERSCOMFIENSA70NMLD <br />X TORVSLIM TS OER <br />B <br />IMPLnveao lunlLlry <br />EL EACH ACCIDENT <br />$ 1000000 <br />ANY PROPRIETORNPRTNEREXECUTNE <br />406012482 <br />O6 /05/06 <br />06/05/07 <br />OFFICERNEMBER E%CLUDFD9 <br />E L. DISEASE EA EMPLOYEE <br />$ 1000000 <br />H }25, b¢st[Ib¢ untie[ <br />E L. DISEASE POLICY LIMIT <br />g 1000000 <br />SPECIAL PROVSIONS b¢Ibx <br />OTHER <br />DESCRIPTION OF OPERAT°X.I LDOAnONB I NENICLES I EXCLUSIONS ADDED SY ENDORSEMEM/ SPECIAL PROVISIONS <br />Re: All Operations <br />City of Santa Ana its officers, employees, volunteers, representatives and <br />agents are named as certificate holders and additional insured per the <br />attached endcrsemenL. <br />*10 day notice of cancellation applies for non-payment of premium. XPXX <br />rcoTICU-AT. Hnl nee <br />CITSAN— SHOULD ANY OF TxEABOVE DESCRMED POUCHES BE CANOELLlO BEFORE ME ExPIRJOHM <br />DATE <br />MEMOP. E ISSUING INSURER WBL RIIgSBIIB�B MML 30* WYBWMlTEx <br />Attn: Tonia Zerbd <br />City of Santa LAna NOTICE TO THE CERnRCATF HOLDER NAMED TO ME Ups.. EIS <br />P.O. Box 1988 M-20 <br />Santa Ana CA 92702 < /Z sommommilm <br />"T,1WrQ3EDREPRESENTATIv <br />ACORD 25 (2001/08) I I Csi ACORD CORPORATION 199E <br />