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ACORD CERTIFICATE OF LIABILITY INSURANCE I 02128I2007 <br />TM. OF <br />PRODUCER Phan: (gOp)39S W5 Fax: 85 5190822 THIS CERTIFICATE IS ISSUED AS A MATTER <br />INFORMATION <br />FITNESS AND WELLNESS INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />380 STEVENS AVENUE, SUITE 206 <br />SOLANA BEACH CA 92075 <br />INSURERS AFFORDING COVERAGE NAIC # <br />2ED_.. _ AV.-a00.3-C95 <br />KARATE DO KIAI <br />CIO MARTIN TORRES N-ao�3-C)`F-4� <br />12692 RANCHERO WAY A A/% <br />GARDEN GROVE CA 92843 <br />POLICIES OF IN LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMLIJ �vvc r <br />REQUIREMENT. OF I TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />REQUIRERTAIN, THE INSURANCE OR AFFORDED BY THE CONTpOLx;RACT <br />DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br />CIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLA Lam^ eaNer EzrwAnou LIMITS <br />TYPE OF INSURANCE I POLICY NUMBER <br />COMMERCIAL GENERAL LU181U MED. EXP (A.iY aye pa,son) <br />CLAIMS MADE OCCUR PERSONAL & ADV INJURY <br />GENERALAGGREGATE <br />aanM1CTS.COMP/OP AGG. <br />COMBINED SINGLE LIMIT <br />NAOe1LL I.Inaau, i <br />(Ea acOderA) <br />ANY AUTO <br />BODILY INJURY <br />ALL OWNED AUTOS <br />(Pa P�oaI <br />SCHEDULED AUTOS <br />BOD0.Y INJURY <br />HIRED AUTOS <br />(Pa ewaela) <br />NON -OWNED AUTOS <br />GARAGE 1JA81UfY <br />OTHER THAN _ <br />AMM' AUTO .��J (/ ( K� / 17 AUTO ONLY: <br />(/ <br />I I EACH OCCURRENCE <br />OCCUR I I CLAIMS MADE <br />DEDUCTIBLE <br />RETENTION E <br />E.L. EACH ACCIDENT <br />E.L. DISEASE -EA EMPLOYEE <br />E.L. DISEASE -POLICY LIMIT <br />DESCRIPTION OF OPERATIONSILOCATIONSfVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTI bFLUTAL. rMU V IOlv,..� <br />The City of Santa Ana, Its officers, employees, agents, and representatives are added as an additional insured but only as respects the <br />operations of the named insured except that liability resulting from the additional insureds sole negligence. <br />Additional Insured Endorsement is Effective: 0212T107 <br />The City of Santa Ana, its officers, <br />employees, agents and representatives. <br />P.O. Box 1988 M-23 <br />Santa Ana CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAILIO <br />DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT <br />FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br />INSURER. ITS AGENTS OR REPRESENTATNES. <br />ev 744t-a <br />Attention: <br />ACORD 25 (2001108) <br /># 53663 ©ACORD CORPORATION 1988 <br />