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FRO^' :C-)A RDMIN /ECON DEU <br />SETT M 'LAKS INSURANCE'ASENCY; <br />!J <br />FAX NO. :7146476713 Jan. 12 2006 07:54AM P1 <br />7148397588; SEP -G -n+ 10:11AM; PAGE 112 <br />ACOM CERTIFICATE OF LIABILITY INSURANCE 09'9"`203 <br />P WAM (71 4)419-140 14039 -7569 <br />Lake lnsueaace Agency <br />13191 Neagort AYe. Spite Ifs <br />"C'#0747473 <br />Tustin. CA 92790 <br />amom Orange FMTdmnls TWerapeatic Art Cantu <br />2" North eroadway <br />Senta Ana. CA 92701 <br />THN CdtTFVAI TH N NNRJED AS A KATTEROF N <br />ONLY AND Cg)* P NO R M UPON THE CERTIFICAT! <br />AFI`f.DiR.711 § �CATAF A D,EXTBID <br />lTOM <br />OR <br />1MSURE" AFFORDIHR COVERAGE <br />NA1Cf <br />ftsuFERx Chai stern Rerita9e Ina. Cc <br />PAPRiEAk <br />A <br />ft%m a <br />om="Uwn <br />X Mw.Enc 4 MERAL UAMM <br />' WM9 MADE MOMMM <br />PmsD"D: <br />AnE.iKa E: <br />09 2 <br />THE POL1CIna <br />'ANY mEflUMEHLEMT, <br />MAYPWAIKTIER4 <br />Pout". <br />OF awmArm U6TlP pm owNAVE REl1 www Tc THE WSVRED MWM ABOVE POR VI* PCU .Y PEPRDO FJWATGD. RO7NICHSTANOW <br />TERM OR CONDn10N OEANY CONTRACT OR OTE+EM OPCIR/H/YNrMR P6Ci70 YaMCN 71 ,S 7EMA WnM1KM ON <br />$LWANCZAFPOROeDRYTM POUCESDESCKMD11Pa7& NR: Mm1EOT TO ALL TME78iAAB.EICUJBKNYAAMa COH ONa OFWeS4 <br />AGGAIMSB LAMM 9HO 1 AMY NAVO OEM nBnucrn BY PAID CLAMS. <br />rTeorRMMAANm <br />uwm <br />A <br />om="Uwn <br />X Mw.Enc 4 MERAL UAMM <br />' WM9 MADE MOMMM <br />571131 <br />08/02/200S <br />09 2 <br />LOMMo6Gmum <br />s 1 000 <br />074 To XW"o"tD <br />UM ev VM uN pywo <br />/ SO <br />1 Sj 000 <br />FEMOO 4ADViNM <br />x 1000 <br />mI-w AWNH An; <br />s z100Dtm <br />x M&cl <br />dMiAOOAWATE UWAPPUesPM, <br />ro,A 99 roe <br />PRDDUM- COINPDPA8G <br />AUTommm <br />IMRxRT <br />ANYAUro <br />ALLM"WALM* <br />R<IfdAIDAVI06 <br />n�DAUros <br />o tl 01"Lort <br />S <br />, <br />3O "- "011RY <br />�� <br />x <br />eaoaY�w aY <br />/ <br />PROPERTYOMMU <br />PvrsPaaPp <br />x <br />- -' <br />B--LN NU" <br />MYAUTO <br />NJ10p4Y- F/.ApfJ1@�T <br />x <br />DMATHµ a,= <br />AVTOOMY: AGs <br />1 <br />I...• <br />xEpCAtlplILIA LIA/IYTY <br />=LR pQA1M.MPAE <br />mg <br />RUMTON : <br />As <br />o FORM <br />F"ODGLIMME <br />E <br />AGGREGATE <br />, <br />f <br />— <br />nDIRM1uoDYaffial nAW <br />MUM"IMOMIN <br />rMyPQ�, AAIINptEXCL=m <br />TECML Yllek <br />c <br />l..ftu1'a $il J <br />-1-r <br />I v,c ATV 00+ <br />El EAt71ACGTDEf17 <br />t <br />EL DISEASE -EA <br />{ <br />LLD - PaMYLW <br />i <br />A <br />slstan <br />Of MMONx/ LOrJMBMEI VGRR1sIF11IXl1y0n {ABGEpRMxNOwaE�rtlxp6pAlwLw+ac <br />ty o SRntR anlL is Marred as additional insures per Torw attacnea. Or1g1nR1 Signed fionR attached <br />SRblact to 10 days notice of cancellation for non- payment of premium. <br />THE MY OF SANTA ANA <br />Community Development Agency <br />Attu: Prank Haroandu <br />PO sox 1999 <br />Santa Ana, CA 92702 <br />ACORD 25 (2001108) <br />aww" AM MTW AVOWS PE•saftMM P 40 WE GANR wRFVPE mg <br />uPmATnw oAn; THeAeOF, nR! dn:ume rxuemevrL3DBDYOpip6 MAa <br />30 OAYax,mTTM/Ra710E lO nECERMHW.7t NOL09LMMmTO TNaLHT, <br />CORPMATM1N 1elB <br />I - . . -1 <br />