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DATE (MWDOl9YYY) <br />ACORDTM CERTIFICATE OF LIABILITY INSURANCE 12@012005 <br />PRODUCER Phone: (5001395-B075 vex toSB)B.&0822 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />FITNESS AND WELLNESS INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />380 STEVENSAVENUE, SUITE 206 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />$81 STEANA ENSBEACA 32075 •^^•�,eeene 1FFOROFD RV THE POLCCI <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURED <br />CHOC V. LE INSURER B: <br />4 FA13RIANO INSURER C: <br />IRVINE CA 92620.2576 INSURER D: <br />INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING <br />ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INaR <br />R <br />A <br />TYPE OF ROURANCE <br />GENERAL LABILITY <br />X COMMERMALGENERALLIABLITY <br />CLNMSMADE�OCCUR <br />POLICYNUMBER <br />EOL9012327-01 <br />POLICY [PPEOTIYE <br />T M <br />12117/06 <br />POMCY PJVIMl10N <br />12117/06 <br />LIMITS <br />EACH OCCURRENCE <br />S 1,00 ,GOO <br />MWM TO RENTED <br />PREMISES FAomuanoe <br />3 100,000 <br />MED. EXP(MY RRD PRLER) <br />8 2SOO <br />PERSONAL A ADV INJURY <br />E 1,00vA,000 <br />GENERAL AGGREGATE <br />$ 3,60G,000 <br />PRODUCTS-COMPIOP AGO. <br />E 3,000,000 <br />GENL AGGREGATE LIMIT APPLIES PER: <br />X POLICY JECT LOC <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOStpw <br />SCHEDULED AUTOS <br />HIREDAUTOS <br />NON-OWNEDAUTOS <br />COMBINED SINGLE LIMIT <br />tee aoddent) <br />E <br />NURY <br />Y ODILIN BJ <br />BODILY <br />E <br />BODILY INJURY <br />(Pv acciWnq <br />E <br />PROPERTYDAMAGE <br />Per eccilMM <br />S <br />GARAGE LIABILITY <br />ANY AUTO <br />AUTO ONLY - EA ACCIDENT <br />E <br />OTHER THAN EAACC <br />AUTO ONLY: AGO <br />E <br />8 <br />EXG938 l UMBRELLA LABILITY <br />OCCUR CLAMS MADE <br />DEDUCTIBLE <br />RETENTION S <br />M lA. <br />) <br />EACH OCCURRENCE <br />E <br />AGGREGATE <br />E <br />8 <br />W CAMPENCOMPENSATION AND <br />lMPILOYEPLOYER9'VABILRY <br />ANr MOPRMTOIwARTNlMXecuTM <br />WPAZIIAIEMEER EXCUJWDT <br />BpE.Buedw...• <br />SPECIAL PROVMIONi Nb <br />_,,. <br />p <br />l <br />�..�� !-.� <br />tux .�+ T <br />Y1 is L.I I l't <br />v .._.... _..'. <br />ay <br />(,. _ <br />MSTATU- <br />TORY LIMBS <br />OTHER <br />E.L. EACH ACCIDENT <br />E <br />EEI <br />EL. 018EASE-EA EMPLOYEE <br />E <br />E.L. DISEASE -POLICY LIMIT <br />E <br />OTHER: <br />DESCRIPTION OF OPERATIONSA.00ATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br />CERTIFICATE HOLDER ADDED AS ADDITIONAL INSURED ONLY AS THEIR INTERESTS MAY APPEAR. <br />CERTIFICATE HLX.UEH <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS <br />WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO <br />City OT Santa Am Recreation <br />GO 80 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS <br />AGENTS OR REPRESENTATIVES. <br />Santa Ana CA 92702 <br />AUTHORIZED REPRESENTATIVE //i�.�J� <br />U61 d 0 Hit e <br />Attention; PEGGY CALVERT <br />ACORD 26 (2001108) Certificate # 33091 <br />I. d OZ80ZVCZ89 'QN/8£:£1 '1S/8E:St SOOZ OZ 03C(3nl) <br />IY XVVRV VVR�v,v�••vr .+.... <br />30NVdnsNi SS3NI73M CNV SS3NIIA N08J <br />