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ACORD DATE(MWDDIYYYY) <br />M <br />CERTIFICATE OF LIABILITY INSURANCE 10/1512009 <br />PRODUCER Phone (800)995 -6375 Fax 18581519-0822 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />FITNESS AND WELLNESS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />380 STEVENS AVENUE, SUITE 2D6 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />SOLANA BEACH CA 92075 1 6LIJE THE COVERAGE AFFORDED BY THE POLI <br />�j — 0La ✓ I INSURERS AFFORDING COVERAGE NAIC # <br />INSURED 1Yp"1 °" <br />FRANK ALANIZ wSURER B. <br />2234 SOUTH TOWNER ST INSURER C. <br />SANTA ANA CA 92707 --- <br />INSURER D: <br />POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING <br />THE <br />TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTTICATE MAY BE ISSUED OR <br />ANY REQUIREMENT, <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 />Ita ADD'L TYPE OF INSURANCE POLICY NUMBER POLM;Y EFFECTIVE POLICY FJ[PMTgN ! UNITS <br />LTR'.INS DATE IM4L DATE UIX <br />DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. IT'S <br />AGENTS OR REPRESENTATIVES. <br />GENERALLIAIIIIm I <br />PHPK284105 10/19108 <br />10/19/09 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />OMHGE TD RENTED <br />PREMISES Eaeavercsl <br />$ 100,000 <br />X COMMERCIAL GENERAL LIABIL.TV <br />MED EXP(My one person) Is <br />2,500 <br />CLAIMS MADE X OCCUR <br />PERSONAL) ADV INJURY I$ <br />1,000,000 <br />A <br />r <br />GENERAL AGGREGATE <br />S 3,000,000 <br />PRODUCTSGOMPIOP AGG. <br />S 3,000,000 <br />_ <br />GEN'LAG GREGATE LIMIT APPLIES PER <br />PRO N <br />X ' POLICY I JECT LCC <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLELIMIT$ <br />ANY AUTO <br />(Ea acadenl) <br />BODILY INJURY <br />ALL OWNED AUTOS' <br />(Pet person) <br />$ <br />SCHEDULED AUTOS <br />BODILY INJURY <br />$ <br />HIRED AUTOS <br />(Per acddenp <br />NON OWNED AUTOS <br />PROPERTY DAMAGE <br />S <br />Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHER THAN EA ACC <br />$__ - -� <br />JANY AUTO <br />S <br />AUTOONLY. AGG <br />EKCESS I UMBRELLA MBREA LIABILITY `'9 <br />/ % -� <br />/ <br />EACH OCCURRENCE <br />S <br />AGGREGATE <br />_ <br />S <br />OCCUR CLAIMS MADE L" <br />L <br />_ <br />S <br />DEDUCTIBLE <br />$ <br />RETENTIONS <br />WC5TLALL OTXER <br />TORY LIMITS <br />WORKERS COMPENSATION AND <br />E. L. EACH ACCIDENT <br />$ <br />EMPLOYERS' UABWTY <br />ARYpRM PARTMJUEYECIItM <br />' <br />E L. DISEASE EA EMPLOYEE <br />E <br />OFFILEwu[uaFA F%aLVO[m <br />E.N. <br />E. L. DISEASE - POLICY LIMIT <br />S <br />rm tlnclnP Under <br />SPECMLPRDVMgNSMM <br />'OTHER: <br />I <br />DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br />It is understood and agreed that the following entity Is added as an additional insured but only as respects the operations of the named Insured <br />except that liability resulting from the additional Insureds sole negligence. <br />CANCELLATION <br />ACORD 25 (2001108) Certificate# 82246 w AL,URLI CVRrVRAIIVR <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 />THE CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA <br />DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. IT'S <br />AGENTS OR REPRESENTATIVES. <br />SANTA ANA CA 92701 <br />AUTHORRED REPRESENTATIVE <br />Attention: <br />J� Frick, CEO <br />ACORD 25 (2001108) Certificate# 82246 w AL,URLI CVRrVRAIIVR <br />