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<br />. ACORD <br />.- ~ <br /> <br />CERTIFICA <br /> <br />OF LIABILITY INSU <br /> <br />DATE (MM/DDiVY) <br />01/24/01 <br /> <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 /> <br /> <br />CE <br /> <br />PRODUCER <br /> <br />LEEDS INSURANCE SERVICES <br />2555 E. CHAPMAN AV. #620 <br />FULLERTON, CA. 92831 <br /> <br />714-526-9393 <br /> <br />SONIA MISCULIN DBA: ELRINCON <br /> <br />FLAMENCO, AKA: ACADEMY OF <br /> <br />INTERNATIONAL DANCE <br /> <br />210 N. BROADWAY <br /> <br />SANTA ANA CA 92701 <br /> <br />COVERAGES <br /> <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 CONDlTION 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 DESCRfBED 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 /> <br />i"N1fA- POLICY EFFECTIVE POLlCye)fpTFfATION <br />L R TVPE OF INSURANCE POLICY NUMBER MM DATE MM D <br /> <br />A CLS0651668 06/01/00 06/01/01 <br /> <br />INSURERS AFFORDING COVERAGE <br /> <br />INSURED <br /> <br />INSURER A <br /> <br />SCOTTSDALE INSURANCE CO. <br /> <br />INSURER a <br /> <br />INSURER C: <br /> <br />INSURER 0- <br /> <br />INSURER E <br /> <br />WllffTS <br /> <br />lOG <br /> <br />EACH OCCURRENCE $ 10 0 0 0 0 0 <br />FIRE DAMAGE (Anyone fire) : $ 1 0 0 0 0 0 <br />~~- u -t., - -- - ----~-- <br />, MI':D f::XP (Any one~!rs..9"~~L" ._i,.~., .____ ___20_Q._Q_ <br />PERSONAL & ADV INJURY $ 10 0 0 0 0 0 <br />---- --.-- <br />$ 10_0.,0 0 00 <br />$ 1000000 <br /> <br /> <br />1 GENERAL AGGREGATE <br />PRODUCTS - COMP/OP AGG <br /> <br />, <br />I AUTOMOBILE LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON-OWNED AUTOS <br /> <br />COMBINED SINGLE LIMIT $ <br />(Ea accident) <br />BODILY INJURY $ <br />(Per person) <br /> ---...---.- <br />BODILY INJURY 1$ <br />(Per accident) <br />PROPERTY DAMAGE . <br />(Per accident) <br /> <br />GARAGE LIABILITY <br />ANY AUTO <br /> <br />OTHER THAN <br />AUTO aNt y <br /> <br />AUTO ONLY - EA ACCIDENT I $ <br />EAACC 1$ <br /> <br />J EXCESS LIABILITY <br />P OCCUR D CLAIMS MADE <br /> <br />DEDUCTIBLE <br />RETENTION $ <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABIUTY <br /> <br />EACH OCCURRENCE <br />AGGREGATE <br /> <br />AGG $ <br />. <br />. <br />. <br />$ <br />$ <br /> <br />~ <br /> <br /> <br />A OTHER <br />SEXUAL/PHYSICAL CLS0651668 06/01/00 06/01/01 $25,000/$50,000 <br />BUSE LIABILITY <br />DESCRIPTION OF OPERATIONSfL.OCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL. PROVISIONS <br /> <br />EL DISEASE - POLICY LIMIT <br /> <br />$ <br />t_L UiSEA.5E - EA EMPLOYEE $ <br />. <br /> <br />THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS VOLUNTEERS AND <br />REPRESENTATIVES ARE NAMED AS ADDITIONAL INSUREDS. <br /> <br />CERTIFICATE HOLDER <br /> <br />X ADDITIONAL INSURED; INSURER LETTER: <br /> <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92701 <br /> <br /> <br />CANCELLATION <br />SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BECANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILf MAIL ~ DAYS WRJTTEN <br />TO .1t:JJtiI THE CERTIFICATE HOLDER NAMED TO THE L.EFT, <br /> <br />ACORD 25-S [1/97) <br /> <br />AUTHORIZED REPRESENTATIVE <br />/C? <br /> <br />TUTZ <br /> <br />