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ACORN CERTIFICATE OF LIABILITY INSURANCE DATlim YYY, <br />TM. <br />PRODUCER (8W)3I'J•IW5 Fw: (I5s)51sOtl2 THIS CERTMATE 18 ISSUED AS A MATTER OF WORMATION <br />FITNESS AND WELLNE33 ONLY AND CONFERS NO RIGHTS UPON THE CERTWICATE <br />380 STEVENS AVENUE, SUITE 206 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />50LANA sEACH CA 92615 <br />N- a O O6 -3(03 -01 INSURERS AFFORDING COVERAGE NAIL 9 <br />INSURED RRANK ALANIZ 11WAMR8. <br />ZZU SOUT14 TOVMNER ST INSURER C: <br />SANTA ANA CA 02707 <br />LISTED eel BEEN M9UEO TO THIE NUMD WANED ABOVE <br />ANY REWIREMENT, T).RM OR CONDIroj OF ANY CONTRACT OR OTHER DOCl1hEMY WITH RESPECT TO WHICH TINS CERTFI('.ATE MAYBE NXIED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREN 8 SUSIECT TO ALL THE TERMS. ExCLUSIONS AND CONDITIONS Of SUCH <br />POLICES. A00REOATELSNITS $ IOW* MAY HAVE BEEN RWVCEO BY PAD CLAW <br />LTA <br />am <br />YVPE OF IMURANGE <br />POLICY NUMBER <br />�MrIrRCrwe <br />�� ampo w" <br />LIMIrs <br />aENERAL <br />1 <br />NAe %.rM�rrl <br />s 100A00 <br />X GDMMERcmtENERALUAI <br />BE <br />MED. EXP ogw*PU.wl) <br />f 2 500 <br />CLAIMS MADIgj OCCUR <br />PERT,O{AL I AIN INJURY <br />i 1.000'm <br />A <br />09MERALAOOREOATE <br />s 3,000 000 <br />GEM. AGGREGATE LsaT APPLIES PEI <br />PROOUCTSCOMP(OP AGO. <br />f 5,000 000 <br />[—Xl POLICY f I PRd LOC <br />AUTOIIMO <br />U"LITY <br />ANY AUTO <br />C USIMBO SINGLE LIMIT <br />(E. A700YA <br />f <br />BODILY INJURY <br />(PurPsm-) <br />f <br />ALL OWNED AUTOS <br />SC46OULEDAUTOB <br />BODILY INJURY <br />(Peraeewf) <br />f <br />HIRED AUTOS <br />W#<ft EOAU705 <br />PROPERTY DAMAGE <br />f <br />DARABE LL ftm <br />f <br />OTHER THAN <br />f <br />ANY AUTO <br />AUTO ONLY: AOC <br />EXcm / uaBRl'LLA LJABLr" <br />EACH OCCURRENCE <br />i <br />AGGREGATE <br />i <br />OCCUR 0 CLANS MADE <br />f <br />DEDUCTIBLE <br />f <br />f <br />RETEMIONS <br />W)RxM! COMPOWTOM AMD <br />wO.t pt.Ew <br />1OA• U"N <br />iJ.. FACH ACCIDENT <br />f <br />EMPLOYEW LIABILITY ITY <br />awn WAMOMMOK041415 raw <br />.►rael+ea.Me. aACwwvr <br />E.L. DISEASE -EA EMPLOYEE <br />f <br />E.L. DKGAiEPOLICY LIST <br />i <br />rw• w••'� �+ <br />r[cw rworaar `+.. <br />O R: <br />DESCRIPTroN of opEmTK *imoCAmONSNEHICLESIEXCLLISKM ADDED BY E DOMMI NT/ SPECIAL PROWL41OW <br />it is wldars100d old agmed MA the following entity is eddod as on addMIMM kWNW IVA only as raspsCtslha OParN"-s Of file <br />rmnod Insured eaoW that BabNky ns(rMdnp balm the addMonsi Inwreds sole aep8yance. Add "ond ku—*d Erdonm w d is <br />EffaNxiveaaia07 <br />'Excq$10 days for Non- PaymaOt Of Premium SEE ATTACHED ADDITIONAL INSURED ENDORSEMENT WA 201011 05 <br />nvLur-m <br />City of Santa Ann Parks, Recraeflon i CDnreunNy <br />Sorvloes Agency <br />flat W. Santa Ann Blvd., SURE 200 <br />Santa Ma, CA 92702 <br />Amen loe: Donna Schultz Wax 0711.571-4235) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED KFORETHE <br />WIRAT10N DATE THEREOF. THE IssLMG INIURER WILL MAE 'A CLAYS WRITTEN <br />NOTICE TO THE CERTFICATE HOLDER MAMBO TO THE LEFT. <br />7� <br />ck. CEO <br />CORPORATION 1988 <br />