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<br />e9/28/2ee7 11:48 <br /> <br />9497584155 <br /> <br />MIKEBRANDOHINSURANCE <br /> <br />90S7948193 <br /> <br />Sep 27 2007 22:23 <br /> <br />~ '. <br />'--- . 'cl.--- . <br /> <br />PAGE e2 <br />".2 <br /> <br />. fARMERS' <br /> <br />r-. .-------;--......---..-.-- <br /> <br />Commercial Certificate of Insurance <br />Ag'f!/Icy <br />NAme <br />..,. <br />^C1clf~ <br /> <br />St. 99. <br /> <br />In~ured <br /> <br />NIIMI! <br />&: <br />AI1dras <br /> <br />. Mi~ S. Brudon <br />. F anncrtIlnAlllance <br />. 31 S83 Oute H"'" 1 0 SlV2 <br />. Rcdlllmll'l, CII. 9~373 <br /> <br />~ Dati lMM/DD'YY) fO'!l/2712007 <br /> <br />___ J <br /> <br />~__~..__....._._.._ ....__...._.. ."..,...........1.. ........ .11I. #' <br /> <br />UIDI the CX!ItI8Da hrlIdllr. nm cer1lIk.dcIIll<<.iW:l. emftt or'&I~ tJ1e <br />COftRP IIrtmIed by the pal1des shown bclCnr, <br /> <br />CompaDtn 'fOOlilling Coyer. <br />c~ A T,tlIcIc IN\\nMe BKbAnge <br />"- . <br />~ B Farfoer$ Insurance ~ch.ngr. <br />~ <br />c_pa~ C MlcI-Cetttury Insunn<:P. C'..ampllllY <br />~ 0 <br />~ <br /> <br />PoIky maM <br />DItli lMM/'PI.'Im'l <br /> <br />ConlfMl1QI - InclllcnW <br />0::1'" <br /> <br />PtoeIucuoComplOPS <br />..... i S <br />Pmonal. <br />M~Jnjary <br />lied OcdIt.rillte <br />FIre D.... <br />Io'ny-" <br />Mriho:all!il~lE2 <br />IArl7 ClI1ll pei1Clil} <br />Cgm~ SlJlgle <br />LllrJt <br /> <br />Dill 30 <br /> <br />Agent 3<l9 <br /> <br />coverages - - . . I <br />ThIs~ to t.JtIl'ylhal the pollclf.s oflnsuI'Dllllrtecl befow t1a1lt been Issued to fbe Inandtlll1ledlbCWt forme pcIIcyPfrJDIIl1ldlcated NQtwlIIDti1lClirc <br />any ml'llrtmftIl. Itfm Il~ ~DI'l 0( my CGnl\"ll(f or othc:l doeumen& wldutspect 10 1YlIIdI tI8t 1III1dktt1 ma, bI! IaUe4 or"}' paul", tile liuUfml'.e <br />IfJ'llfll~ by tIw poIItIP.:s dml1btrl hm!1lI. ilsubJed <<). AD 1M terms. oclnllons 3fI4 condItlans aI SIICh poatde. UmlIa 31iC1wn may baq been ledllM by <br />. d tIfImt. <br /> <br />1)IplI of Inw~.C~~:=L_..~~::~ Nu~be'.. <br /> <br />GenerallillbifRy <br /> <br />Co~l Gmeral <br />1I1l1ll1l, <br /> <br />- Occ\UI.I\U Vemon <br /> <br />. ~r_"R'~~ <br /> <br /> <br />I A\JtomolJile t.ia btllty <br />All Owned ("ol:lll1el'Cla, <br />"ltl(,~ <br />X S~bed..hld AuM <br />" HImf AIUIn <br />I t( t\OIl.O\Jn., t.~t1)1 <br />i GMI&e Ulhjllly <br /> <br />k4 1ATtIr~ ll~~!.i:Y' I <br /> <br />I WrorIC.8fS \':OII.JltflJ~llurl <br />I and <br />ElilpIoyer~' l~bllity <br /> <br />DtsctlpClon Of OJ)er.,tltms/Vl'h1c:.lwRestrlctlon~lSpetllllltcmS: <br /> <br />1995 ChcvroJer "seA) V:u11J!1~97 1999 TQyota TacolNI ~628 <br />2000 Chc:vrOlct C3S0[11f14042 200S Ti;Jyo14 Tacoma#3lU69 <br />2000 Forti HSO PlUp #52128 2004 CheVlolct ExpteJl .Van~27l6 <br /> <br />c.... <br />._L": <br /> <br />. I <br /> <br />^ <br /> <br />. DnlWd RbodC$ <br />. ,W.ur Ift~. <br />. 11 -A MBrconi <br />. lrviIlc. Cr.. 9261 tt <br /> <br />A/~O'1-I;<Y <br /> <br />$ <br />S <br /> <br />s <br /> <br />s <br /> <br />I. I,Wv.IJW <br /> <br />~ <br /> <br />S <br /> <br />, <br />S <br /> <br />$ <br /> <br />Cel'tlflQte Hol~r C8m!IIatkln . <br />. CITY OF SANT ^ ANA Sbou1d1l'lY oftblllbuva _filled )'OlIdel bnlllce.llecl bl!for~ the ~Ion'dm " <br />Name . 21) CIVIC CE:'orTER. PlAZA rllmof, dx 1IIltl1nlentnplrly\\4J1 emIovor..to~l3Qd~ wrf(!eJ1 Jl()(1te fO r.lIt <br />&. . RO_R~An'llc" (M-) tl!tftna~hoJdtr MIJIt!d 10 the Jefl, hilt Mure'l!o 1M. utth n"tk~shlln '11I1'O,e lW <br /> <br />~~:_' $A~AAN"CA'"'' ~~_"C~"~_'_' i <br /> <br />)e.Z4~ 4-"" m. ... Copy Distrlbution: SeJ'\'ke Cenrer Opy Agent's Copy HI\I <br /> <br />",.....,,,,,,,r.nt.j <br /> <br />I <br /> <br />I <br />I <br />I 0910412001 <br />I 09104/2007 <br />09/0412001 <br />I <br /> <br />~Z008 <br />C9/()4/200S <br />09JOr412008 <br /> <br />BodIly InlWY <br />rnr ,inoi) - <br />101111, h~r1 <br />(per altllllitll <br />Prapllrty."..llSe <br />G...~tf <br /> <br />" <br />UmK <br /> <br />ell,.tc () \, ly' <br />/ <br /> <br />~ <br /> <br />094389020 <br />. 094389020 <br />094389020 <br /> <br />StabJtorj <br />EIdi Accftlrm I <br />OIHUe -l<<J)E~ I <br />Orawe . 'f!bllr., Um" I <br /> <br />200s CJaevrOlctCUOO ,-,d09 <br />I997WeJl, C....o Trailoc J29SOfi <br /> <br />G/~~. <br />/./ / <br /> <br />I <br /> <br />I <br />