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- -2007 00:29 AJG <br />-i r `T 11"S ! > e! - a e W <br />P.01i02 <br />/-'T-^'�"�'u wVl\ 1 11 ■\II'� 1 4 V■ 1..!!'{V!r! ■ ! !!\Mwl V'\I\wvI U4111ILUUT <br />FAX (425)451-3716 <br />Risk Management Services, Inc. <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHT$ UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMENC, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE P01.1 JESSELOW. <br />R46URERS AFFORDING COVERAGE <br />NAIL S <br />--see. Amusements, Inc. <br />- R^"x P97 <br />fiscandido, CA 92033-0997 <br />w wRA American States Insurance Co <br />INSURER a <br />rRNVRC; <br />INSURER 01. <br />N E: <br />'r 1E M'� 11ES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD DAICATEC, NOTWrr"STANOING <br />P .W xC JIRE%WNi. TERM OR CONDRION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CEI TFICATE MA" BE ISSUED OR <br />;.'A" V E: -A!A. THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CC NDITIONS OF SUCH <br />POLICIES- A60MGATE !MATS SHOWN MAY NAVE BEEN REDUCED BY PAID CLAIMS, <br />'=, c?i T'�OFwsuRAMeB <br />►OUCY NUIMMm <br />POLICYPo <br />tlMlia <br />EACHOCCOWNCE <br />$ <br />:C�VVZQCVLGRNEWWUAAILRY <br />DAW01!TO FIEWIDO <br />S <br />CUVM$MAIZE ❑OCCUR <br />MED EW(ANI one 9a�^l <br />5 <br />PER9OHAL6ADvwURY <br />S <br />GENERAL AGGREGATE <br />$ <br />CEO'. AGGREGATEpLIMIT APPLIES PER <br />PRODUCTS-COMMPAOE <br />$ <br />LOC <br />DICH44116101 <br />04/01/2007 <br />04/01/2008 <br />WMBwED SINGLE LIMIT <br />(Es acdoom) <br />a <br />1,000 <br />BODILY (AWRY <br />IPaf pa ) <br />S <br />SCHEDULEDAUT09 <br />- +9:V MACS <br />— ..._ .. ... <br />BODILY INJURY <br />(Per We ) <br />y <br />PROPEfMDAMAGE <br />(Pw p[adeAtl <br />AUTO ONLY - EA ACCIDENT <br />S <br />i <br />�� <br />AGE L'ABMJTY <br />OTHER THAN EAACI: <br />S <br />ANY AUTO <br />AUTO ONLY: Arl; <br />$ <br />---'2'LaI L?ABILRY <br />.. OCCUR'. CLAIMS MADE <br />EAOHOCa1R1ifN[`.E <br />S <br />AGGREGATE <br />S <br />$ <br />DEDUCTIBLE <br />i RETemDN S <br />5 <br />- ^^"'R°_ CDNFTNy1TNUM AND <br />YUC STATT 11- <br />E.L EACH ACCIDENT <br />S <br />^'`._.,•=R;^71PARTNERIEXECl1TIL'E <br />%rrA18Ea SfGJJOEDT <br />f I`yyx�; :cute meM <br />$FE.. J, FRpVt$i0N5 Mitre <br />E.L. DISEASE- EA$AWLOYI' <br />S <br />E-L DISEASE -P000YLRAI' <br />S <br />:IMFI VVHWAM <br />I E=LUNOM ADDM 6Y 6mmBlan'I50Etlu.asnwwx <br />i"ni, its orricers, agents, enploy"S, representatives and volunteers are included <br />,G iv a; insureds but only as respects the operation of the named insued per policy terns and <br />` :_rT "`ter the dates June 2S, 2007 through July 3, 2007, <br />City o4 Santa Ana <br />,`.-t TP Carla Tompkins <br />`i. Santa Ana Blvd., i200 <br />"Pa, IA 92701 <br />SHOUIO ANY OF THE ABOVE DESCRIRED POUCB6 DE CANCEL LED BEFORE THE <br />WMIRATION DATE THEREOF, THE ISSUING INSURER WILL IM;x GMAIL <br />30 DAYS YIRnTom NOTICE TO THE CERnmATE HOLDER NAMED to THE LEFT. <br />CACORD CORPORATION 190 <br />