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;02 -26 -02 09:16 FrdR -FROM 60C COHERCIAL DEPT 5093251903 7-033 P.02/03 F -991 <br />CERTIFICATE OF.INSURANCE 0772915 <br />PRODUCER - <br />K 6 K IA +llrdnCe Graup, I71G. <br />1712 14agnavoX Way <br />THIS CERTIFICATE IS ISSUED A., A MATTER OF INFORMATION ONLY <br />AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS <br />CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE <br />COVERAGE AFFORDED BY THE POLICIES BELCW. <br />P.O. Box 2338 <br />Fort Wayne, In 46801 <br />COMPANIES AFFORDING COVERAGE <br />INSURED <br />COMPANY A TIG PREMIER INSURANCE COMPANY <br />LMER <br />SKYHAWKS SPORTS ACADEMY, INC. <br />D /B /A SEE ATTACHED <br />P.O. BOX 18529 <br />SPOKANE, WA 99228 <br />COMPANY E3 TIG INSURANCE COMPANY <br />LETTER <br />COMPANY - <br />C <br />LETTER <br />COVERAGES <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY <br />PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO <br />WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO <br />ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO. <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />ICY EFFECTIVE <br />ATE (MMIODIYY) <br />PQ eYeXXP TiCN <br />LIMITS (in thousands) <br />LTR <br />B <br />General Liability <br />® Commercial General Liabaity <br />claims Mader OCtur. <br />claims ® <br />Owner's a contractors PrOccurrence <br />T7 3804275301 <br />22:01AM <br />2/08/02 <br />12:01AM <br />2/08/03 <br />General Aggregate S 200 <br />11`165= omPIOW Agpegno <br />S 1000 <br />Forecast S uo <br />Adnning InFav <br />S 1000 <br />Each Occurrence <br />S 1000 <br />Fla Damage IAaY one roe) <br />S 3 00 <br />Meciesl Eapons0(AflYOne Person) <br />S <br />❑ <br />PMiciIRIM Lagal L:e4Yl'r <br />S <br />B <br />AutOmobile Liability <br />y <br />Any auto <br />All Dulled autpS <br />Scheduled autos <br />T7 3804275301 <br />12:O1AM <br />2/08/0: <br />12:01AM <br />?/08/03 <br />Combined <br />Simile <br />Limp <br />S 11)00 <br />= <br />Bediry <br />Injury <br />Im oenico,� <br />Baddy <br />®Hired autos <br />©Non-owned autos <br />®Garage Ljebikly <br />Injury <br />rari' <br />S <br />S <br />PlopMy <br />Dairies* <br />B <br />A <br />g <br />Excess Liability <br />Q STRAIGHT <br />El Other Iran Umtaellaform <br />WorNers' Compensation <br />and <br />Employers' Liability <br />Participant <br />K:.g3922239700 <br />WC 8047327400 <br />T7 3804275301 <br />12:01AM <br />^_/00/02 <br />12:01AM <br />2/08/02 <br />12:6mm <br />210810 2 <br />12:01AM <br />2/08/03 <br />13: 0 1A <br />2/08/03 <br />12:01AM <br />3/08/03 <br />o un�onco Asgragaw <br />= 1000 S 1000 <br />Statutory <br />S 1000 E=hAc4;idwf <br />DMW <br />s loon pieeeee.PONey Llmil <br />S I a n n Dieirau -Eeeh Em <br />AD&D S NONE <br />9 NONE <br />Eel:esa Medieal <br />Weekly Irasmm s X NON <br />Accident <br />DESCRIPTION OF OPERATIONShOCATIONSNfHICLESIRESYRiCTON- ,SPECIAL ITEMS <br />CERTIFICATE-HOLDER CERTIFICATE-HOLDER IS LIST <br />CERTIFICATE MOLDER <br />CANCELLATION INSURED <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE <br />CANCELLED BEFORE THE EXPIRATION DATE THEREOF. DAYS <br />ISSUING COMPANY WILL -9066" b!� ( <br />WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO <br />THE LEFT. <br />City of Santa Ana — Parks & Rec. <br />Dept <br />888 W Santa Ana Blvd 27J Floor <br />µ,rwORQ6D ngP iG. Tn <br />Santa Ana CA 92701 <br />` <br />1.9J <br />SLJY <br />K:7 bz L u-N 5, Q <br />S <br />C"'--VA CL.- ja , q3.7 01 <br />