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ACORDTM CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MFWDD/YYYY) <br />0811312008 <br />PRODUCER Phone: (8001 39545075 Fax (858) 519,0822 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />FITNESS AND WELLNESS <br />380 STEVENS AVENUE, SUITE 206 <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, E%TEND OR <br />canna eccCiROED BY THE POLICIES BEL <br />SOLANA BENCH CA 92075 <br />POLMY EFFEU. <br />WTE PWDO <br />POUCY EIIPWJTCH <br />DATEwM <br />LIM95 <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />_ <br />INSURED <br />RAYMUNDO SUAREZ <br />Agenc�Licp_ 0377,645 - <br />INSURERA: Philadelphia Indemnity Insurance Company <br />INSURER B: <br />_ <br />610 S TOWNSEND STREET <br />INSURER C: <br />SANTA ANA CA 92703 <br />INSURERD: <br />Je Frick, CEO <br />COVERAGES <br />TO THE INSURED NAMED ABOVE FOR THE POUCYPERIOD INDICATED, NOTWITHSTANDING <br />THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN 5SUEO <br />TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAV BE ISSUED OR <br />OF SUCH <br />ANY REQUIREMENT, <br />POLICIES RIBED SUBJECT TO ALLTHE TERMS. EXCLUSIONS AND CONDITIONS <br />MAY PERTAIN. HE IN URAN E AFFORDED HAVE REOUCED CLAIMS. <br />LIMITS <br />AGG <br />IVSR ADD 'L <br />TYPE OF INSURANCE PI OLICY RDMBER <br />POLMY EFFEU. <br />WTE PWDO <br />POUCY EIIPWJTCH <br />DATEwM <br />LIM95 <br />LTR iNSa <br />GENERAL LIABILITY PHPM 105 <br />06115108 <br />06115/09 <br />EACH OCCURRENCE $ 1,000,000 <br />pNMCE TO RENTED <br />PREMISES IEa o¢unme) <br />$ 109,000 <br />- <br />Je Frick, CEO <br />Attention: $ _ <br />MMERLIAL GENERAL LIABILITY <br />MEO. EXP (Pny one perspn) <br />$ 2,$60 <br />CLAIMS MADE IX OCCUR <br />PERSONAL a ADV INJURY $ 1,000,000 <br />A <br />GENERALAGGREGATE S 3,000,000 <br />PROWCTSLOMPIOP AGG. <br />$ 3,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRO - <br />X POLICY JELT La <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT $ <br />ANY AUTO <br />jr <br />(Ea amidwt) <br />' <br />INJURY <br />ALL OWNED AUTOS <br />J <br />(P., <br />(Per person) 8 <br />SCHEDULED AUTOS <br />- <br />(BODILY INJURY <br />(Per .¢(dent) <br />$ <br />HIRED AUTOS <br />NON- OWNEDAUTOS <br />PROPERTY DAMAGE <br />$ <br />IPer aa,denp <br />GARAGE LIABILITY <br />AUTO ONLY -EA ACLIOENT <br />$ <br />OTTER THAN EA ACC <br />$ <br />ANY AUTO <br />,,$ <br />AUTO ONLY: AGG <br />EACH OCCURRENCE <br />S <br />EXCESSIUMBRELLAUABIUTY <br />F— i OCCUR i� CLAIMS MADE <br />AGGREGATE <br />S <br />$ <br />DEDUCIBLE <br />-- <br />RETENTION S <br />$ <br />WC STA.r OTHER <br />TO A <br />WORKERS COMPENSATION AND <br />E.L. EACH ACCIDENT <br />S <br />EMPLOYERS' LIABILITY <br />E.L. MSEASE -EA EMPLOYEE <br />S <br />A r 0PP 110"AIItnWW0CECMTNIE <br />S <br />X p•. e.•cro•.�an <br />E.L. DISEASE-POLICY LIMIT <br />'sPECUI PFIDNBIOIB Eebw <br />OTHER' <br />DESCRIPTION OF OPERATIONS ILOCATIONSIVEHICLESIEXCLUSIONS 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 />Policy is Non-Contributory. <br />Additional Insured Endorsement is Effective: 07123108 <br />CERTIFICATE HOLDER <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 />✓ <br />DO $0 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS <br />CITY OF SANTA ANA <br />AGENTS OR REPRESENTATIVES. <br />20 CIVIC CENTER PLAZA <br />SANTA ANA,CA,92701 `�� <br />AIJTHORREO REPRESENTATIVE / 7 <br />- <br />Je Frick, CEO <br />Attention: $ _ <br />m wrnen rnoDrsoeTiON HARa <br />ACORD 25 (2001108) CenRlCate 9 11611 <br />