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<br />JQ"l-17-22l05 10: 58 C"r,o'Yr: 3PE::I~~ Ty' RISK I''JC <br /> <br />3033?93S:::3 <br /> <br />To:714 571 4,~3S <br />I <br /> <br />0.1'2 <br /> <br /> <br />-rl - ?Oll'f- ?5l-o I <br /> <br />.~:WidgmID ~t~lllii[!:llit:~!~:~ll,ltt.. OA. 1I\~,~6~~/YY) <br />THIS CERTIFICATE IS' ISSUED AS " MAlTER OF IN'OftMAl'ION ONL. Y <br />ANO CONFERS NO RIGHTS UPON THE CERTIFICAYe; HOLOfR:, IM'S <br />C'iRTIFICA'T'E OOf$ NOT A~eNt). E)(r&ND OR AI. TI5R THE COVERAGE <br />AFFORDED BY THE'POLICIE' .IH.OW. <br />COMPANIES1IAFF?RD~NG COVERAGI! <br />,I <br />OOMPANY CAPITOL speCIALTY INSURANCE CORPORATION <br />A Ii: <br /> <br />, <br />I <br />VOIJT'" SPOFtY'$ ASSN. PURCHASIN'G oJROUP <br />il <br />Olympic. VOl:Jlh Soccer League <br />1221 North rl~atc:; Stf~el I~OM"'AUY <br />Sanla AM. CA 92703 c <br />I[ CERU 5/317 OOM~AN( ii! <br /> <br />!@Y.~Blg',. ~~l~'" .' ~m~"'" ~ If I l!DlBD!Jiil_~:!.' , : ,I "I' ~ I i ~I ~..JJ:!;;w~i]itJ.]{lri <br />T IS IS TO CERTI~T~^TTMf POU(.1t::.i OF rNSURANCl;; LISTt;Q Dt:I.OW 1.IAVE eeEN ISSUED TO THE lNSUREf:J NAMED AE\OVE FOR THE POOLlCYPEFtIOD <br />INDK:.A.TEO, NOi'Nm~\~"\"AND\NC ,t"tly RE(.)U\R~MFNl, TERM oA eot-."D,,.ION OF ,tiNY' COl'fl'RACT OR OTHER tlOCtlMIiNT WITH RSS,f'ECllO WHICH THIS <br />Cl;R,TlrlCATE MAY Ele!ISSUED OR MfI,)' ~RT"'IN. TM!: IN9uRANCE AFFORDeD ~y THl: POI,.ICltS CC!lCn.lDI!O He:n.I!IN IS SU6JECTTO 'LL nit: TCrtM3, C.\(CLUSIONS <br />ANO CONOITIONS ()~ GUCI.t POLICICC> I IT55H N MAY I-lAVF RFFN RROUCEO 8y' PAlO cv.l.''''~, II ._ <br />. POLICY II <br />Pnl,IC'fCF,t;CTI\lt; t"'Dl""I'IUfjUA.I~1 <br />ru, TF U/DClVY MNf1)Orv ", <br /> <br />" . <br /> <br />INsufl:E <br /> <br />III <br />, <br /> <br />C')MPAN.( <br />B <br /> <br />'" <br />ill <br /> <br />co <br />ll'R <br /> <br />'NilE O'IN$U":"NC <br />GENflitAI.. IJA II. TV il <br />X CQMMI!:"CI.IU.. OCN!J>w' ~1^Ollirv <br />Cl.4IM$ M1>lJI. II !Xl ~<';CIJ <br />OVJNf.~" (1l"ltn"'A':TOR':t ~,1J1 <br />X ~;,~I,~~~T~lEf!e I) <br />II <br />_ UTOMOIILI UAI1III.'H II <br />ANY AUlO <br />ALL OWNED Aulas <br />SCHEDULED AU. ~IOS <br />HIRED AU10S \ <br />NON-QWNEO ^UrOS <br />I <br />II <br />G"'AAG' LlAIIILITY ~ <br />- MolY AUIO --1'! <br /> <br />E}(ofSS I.IAlll.lTV II <br />UM{j,RiLV< rORM i <br />orHI!'~ THAN UM"~FI.l^ FORM <br />WOJo(ll,\,I(':;'i;;O"'..EfO'An NJUlO <br />nlPLoyMl'l.I.'I6lL1TY ;11 <br />n4liI'RlO".IG~ <br />jOMIHliilllMilli(UIIVE .1,1 <br />....11\l~~.""", . <br /> <br />..OUCY NUMflFft <br /> <br />'II ~K.RAl.l.lJl.Ml.Cw..TC. <br />III P~OOIJCT3-()OMP/OP AGO <br />m <br /> <br />\11 <br />ill <br />II <br />" <br />II <br />::1 <br />Iii <br /> <br />A <br /> <br />P'ER&oN/\L &I\O\J lNJUfl.Y <br /> <br />2/1107 <br /> <br />211/06 <br /> <br />CS 216051 <br /> <br />EAC~ oCC"J"~l!'NCE" <br />""II CAW\GC! (MI' or.o!'nll <br />t,1EO iiC~ (A"r ~n~ PB';;;;;-- <br /> <br />C(l",/(tI/oJ(llrW"'~I,CLIMIT <br /> <br />eOOllYIN.JUIt)' <br />(Plf,,...,;oynl <br /> <br />Ll(,l(lllY UJUj~y <br />(o&ora.;dOont) <br /> <br />PIU'T'f'flIryn.llM.ll(",f." <br /> <br />.11 Al.ITI"l OHI,Y.I':A A~flII)I".:NT <br />I OTHflllTH4NJlJJTOON\.Y. <br />,i, EAGH "'G~.OENT <br /> <br /> <br />"l.;"~m;.<')"':n~ <br />i!,III:AC~!"I(;(;I,Ir'Ol!NCE <br />!.: "'1,.Gf~(;(;"':'~ <br />'ii <br />., <br /> <br />'I'~':I' ~~T~~i" <br />, t:l CACII AIXIOCN'I <br />l!':l. DistASI!. POliCY ~/Ml" <br />'ii <br /> <br />1~1. <br />EXC <br />I <br /> <br />FLOIflFA6".FI>.I;MI"l('Nf.f. <br /> <br />LIMITS <br /> <br />~ 2.000,000.00- <br />$ 2,000,000.00 <br />$ ',000,000.00 <br />_$ l,OUI) 000,00 <br />$ 100,000.00 <br />$ fi~M'Cl.OO <br />$ <br /> <br />$ <br /> <br />s <br /> <br />s <br /> <br />I <br />$ <br />$ <br />$ <br />$ <br />S <br /> <br />$ <br />$ <br /> <br />OTHFR !I 'II <br />I'. II <br />II I,ll <br />Ii " <br />DE8CAI"'TION OF Of'CrtA'TIOHSIlOC,A,TION!SNEHleLUIIlPICIAlITEMS :'\ <br />Thfl Cortlficate Holder isadrlAd a~ an add\tkmellnsured b~t only w.lth respcct to liabHlty arh.ing ou~:or the up~ralions af the above nrJmed <br />insu~ ~ ~ <br /> <br />il iii I <br />CH!A~Itt '~~~t~W~~ t~~~~~~.~ <cll~:,;;~;~~Mt_fui\ '1~~':~I.~~~tjll' 1I~~~jjW : ,;4ill , \")~ili\~'r,':',~~:~m~!'Lkili~~{.~ui~~;, <br />I SHOUI.l;l ANY OF' nil:; AGOve D ~CRIDCO P'Ol.ICltS DC CANCEI,.I.CO IJCFORi;; lJ.4:: <br />I (I(PIRA-TrON DATE THEREOF, T~E ISSUING COMPANY WILL ErJOEAVOIil' TO MNL <br />. I , ~t'JA.,.s \MtITT(N NOTII;:I TOJ1'rIol1! CfRTI"ICATf IoIOLOII!:" NAM'I;I) TO TWI!" 1.1!~, <br />City Of Santa tna Parks 4 ~eCrei:llIOfl Bur,..All.U,U:: TO MAIL SUCH NOTleE SH....I.L JMPOSE NOOD~IGATlON ,0'" I.IADI1.,'T'( <br />Attn; Lucy :1 OF ANY KIND UPON Till': COMPAhlY ITS AG[NTS OR R[PRt:StNTATlVES, <br />886 W. SM18 'AM Blvd Ste 200 AUcrHORIZEO "ep"eseNTA~''''' <br />Santa Ana. C~ 92701 1:[ <br /> <br />!I' JI <br />I ((I <br />. III <br />'i ... . iil . l~~(t,..,..' <br />r:i~~I)R~$\'$1I!fIV$rc:i!::;;:1I!1iI:lllIlI1I~~"l~m'~~~;llrnm,Ill~lIII!i!rl!''''!:irrnlill;11':l:i1'~il1TIl!.,"llIWIWiil1~IimI~IIlIllliIIllll~!II!:j''''''"IIl~lII!lli!l<ll'I1ltClI!I~il1lIilR"IiIU,ll:<l1II'i.~.'1 <br />1\ i'l <br />I {; ,I, <br />(J ,yll f8~j;2--- li[ <br />