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<br />n..c 07 01 12: 03p <br />12/07/2001 13:54 FAX <br /> <br />pacific <br />8772871 ',15 <br /> <br />coast bottlint <br />TilE IIARTFIlRD PAC <br /> <br />714 <br />T <br /> <br />957 <br /> <br />8699 <br /> <br />p.4 <br /> <br />141001 <br /> <br />'-' <br /> <br />'wi <br /> <br />IhEZ <br /> <br />fA CORDCERTl}o'I!~ATE OF LIABILITY INSURANCE December 7, 2001 <br />~n.!.,..~r TlIlSCERTlnCATt: IoS J!:!!iVED AS A MArTt;.R (If <br />2.l071l5 INFORMATION ONLY AfliD CONFERS NO RIGHTS urON <br />P;ychcx InltrTonJnl nlE cunlnCATF. HOI.DO_ TIDS CF,RTfFlCATE <br />1.1 e ~bnr()n! Don NI)T AMl.::\'D, EXTEi\:l.l OJ/..u. TER THE COVERAGE <br />3C!fJnnin8tOll Av~nur AF}"OJWfSD BY TNt t'OunES BELO\\', <br />F''''''''gto:t,CT <br />l.ICHH91) <br />I..~;;J-----'-- <br />P/.ClFfC COAST nOlfl.'?o:G COU'OM TION <br />f)HA; <br />It01 P.II,RK..CUURT Pllif20Q <br /> <br /> <br />SI >ITA "NA,e,,- <br />~HOl F~",:'H4\l~786<W <br />iiiE POLICIES or IN!UiA;.;cif JSTI"i)iiIT-ow HAVE UiiE:"-ISSllED m'iHil',JsUIl.ED NAMED ADOYB fOR THI;; POUCY pERIOD <br />INO/eA IfD. !\01 WlTHST I\Nllf.JG ^~'Y REQUI:tJ;MENI, TERM OR CONDmOil Of AJIIY CONTRAC. OR OTHtR DOCUMeNT V.1TH <br />RlSPECT TO WI-UCHTiHS C[!\~-lflCA1EMAY Ell: l~'SlIEDOR MAyrERTA.N, -nu; 1NSURANCE Aff.ORDm RV 1"HE POLJ('ll:;S <br />or SCRWt.v HEREtN ,S SlIDTI'C 1 TO A.l.L TffE Tflt'\1:5, EXCLUSIONS AND CO:-,UlflONSOf SUCH POl.lCUS_ AGGREGATE' UMITS <br />Sf OWl>.' MAY HAVE !lEEN R}D JCEDBY PAID CLAIMS <br />GClltr:;oIU:;obilily - Inl..rrr; <br />C(l'lllmfcjalGclI(r.lIU~1li]ity <br />CLinlsMlld:; <br />Ol."~UJ' <br />PO',c)'N"",bc. <br />"(licyEllCcli~tDJle <br />I'cli~yEJlpi!t Dillt- <br />G~ 1~",1 ^-~f;rt::Olc l.im'I Appli". Pu <br />Policy: <br />J'rcict!: <br />LOC <br />A"Ii)tI.ebiltLbbIHIy <br />Au'^uln", <br />AlIOWl\Cd^\.llo~: <br />S;:lcdu1edAl>cn. <br />Hil;dAII!\l,; <br />r..'a"OwncdAulD. <br />Po; cy Numbcr <br />Puleyffk.:I"IC'D,J[l.": <br />Pol tV ExpiDliollOa'~, <br />Cl'lCI'Lialllliif <br />An.AII.".o <br />f'ofcyNurnbcr: <br />Plllc-yEllCdiwl!nlIC' <br />_~c'1f.I';',~h'm~_ <br />I);Il'nLiabilil)' <br />OttWTtl1CC; <br />C1i1:nuM~de: <br />DenltliblC': <br />I(e~,)llion. <br />P(li,:yNloIlllbcc. <br />1'<;>1"ybir..,ri.."n"IC_ <br />roli~J.tJlpi/':)lionOllie~ __ <br />WG-.kU'.C9ffij'i/luriaol <br />& F.....Io}fr."jLiabibl)' <br /> <br />InJ..rru_lf"(lrdU.ICOYfr~ <br />InSlIm ^ l-lARTFORD UNDERWRITERS, f.'\'S co <br />ImwerB <br />tnsllftrC: <br />InSlIfCrD' <br />In$wtrE.; <br /> <br />LimilI <br />E.acbOcet~lICe <br />f;re~$C'{;myomfire) <br />M"" ~i* (any 006 ptmft) <br />Ptnlm<ll& Advli.bility; <br />Gtn(;J;uA;~g~.Ie: <br />Products- :<impIOpAllg: <br /> <br />, <br />, <br />, <br />, <br />, <br />, <br /> <br />Jns~'",; <br /> <br />L1mils <br />Cumb Smile Limh(ea aeeident): <br />ijOlti~'lnJlry(Ptfpetlilln): <br />DOdilyll\j'ry(PuAtl;idc:nl) <br />Pmpuiyn nlUlJt(Pt-t Att:idc.ltJ <br /> <br />, <br />, <br />, <br />, <br /> <br />IllIu,en <br /> <br />limllli <br />""!<;IOnl,, [A. Ac.,ilknl: <br />~r1"li~nA\lIDOrUy> <br />EAAecide'll; <br />A i.lr. <br />Undll <br />[jlKho..~..."'noo; <br />Argltl!.'lC <br /> <br />s <br />, <br /> <br />[n...rr,.: <br /> <br />, <br />, <br /> <br />Lilnib <br />WCStarlrtD-ylimtl!: <br />Olhcr: <br />Polly NUIl1t>cr' 7t-WE GYl90S fL Eull PccilllfJll; <br />Poli:y F.n-~'t1i..c D~Ie. 17 .ocr -01 E.L. Di.irn~ _ EA Emp~e. <br />"oh''iE.~i""lionQ~_____11_"OCT.Ql e.L Oi~S:. .PDlic:y Limit:_ <br />Dn-'riptloo of lIptnl'iffn.IJofOlIi(l;IS).'dlidoElln"du.ioM ~lIdetl by cndllnrmfllusp.-daJ )r-t'"KID~; <br />WArEllBOTTLlI'Ii(; <br /> <br />Ins......:A. <br /> <br />x <br /> <br />SI,OOO.ooOoo <br />$1,000.000.00 <br />51,000,(:00.00 _ <br /> <br />(cr'iRcatclloldrr <br />ATlN,THOIV/ l'OV(,HR,,\N <br />CITtOFSA.NT^^NA <br />UO-A S DAISY AVENUZ: <br /> <br />S..."TA ANA, CA!,l270l <br />F;1X ~ '( <br />Ilert"n~r N~nWtt:l)]21-iiocnJl <br /> <br />C....~U..lio, <br />SIIDlIldlny-,fOltJ\lovt deitnllrdpohclc~belC"T.te\edbefOTtlthc <br />CIIpirlltioilllolr1hct'eof,lhei~~uioE:inmrctwin~I".....jllndil,\'l: <br />II'rinf"ROti(cto lItecertio,calC ttoidun.1med III the len, b.1i -I h. J <br />-' Lt. ,- .. ,- f ,I" J r '1 <br />" <br /> <br />...UTI-IORII ED RF-I'RESENT A nVC:. <br />J-j--- <br /> <br />APPROVED AS TO FORM <br /> <br />.tt:~~ <br /> <br />,)cputy City Attorney <br />