II ,~ i 'i - __ C i~r F~:+ I ~ -'~ IJ F4~ ? C.I P II I_L~~~II,
<br />f-I_'1=-_I_-i'.IQ i .T'` 'r I. , . ~ ~,F- II"I='J~ '_>-i~_- gP'ICb _~ ~ --
<br />~- <
<br />OATEIMtMIUr)lYYYY; i
<br />I~C~R>a CERTIFICATE C?F ~.~A~ILITY INSUkfA~IVC~
<br />_n, 8!3012 0"l
<br />PaoDUCEa TFfIS CER7'IFIGATE IS ISSUfrn as A RIIATTEI~ OF 1NFORMA710N ff
<br />ONLY AND CONFERS NO RIGHTS UPON THE GERTIFICATE 1
<br />RFP INSURANCE AGENCY THIS CERTIFICATE DOES Nc?T AMSNd, EXTEND OR
<br />HC~LDER
<br />56A1 W6ST 3LAtJ30N AVE., 5U3TE 250 .
<br />~/
<br />~~ AL7E14 THE COVERAGE AFFORDED BY Tl~E PQLICIE3 BELOW.
<br />~ 2(~
<br />-'~~
<br />C13LVER CITY, CA 9U23~ /
<br />r
<br />1
<br />Phnn6 (310) 642.1933 Fi'tx (310) dd5-315tl I
<br />I
<br />~ IN5URERS AFFORDING GOVERAG)= _ NA)C k
<br />."-'°_.
<br />~
<br />IN9yRC-D
<br />I
<br />' ~ BUR! INGTON INSURANCE t~©MF?ANY
<br />INsrr+ERA -
<br />1t7N CORPO
<br />L`IViC COL.LECT
<br />`
<br />~-
<br />F2ES pi21VEr
<br />E RATION .
<br />INSURER B
<br />~
<br />-
<br />l __
<br />---
<br />R,
<br />1565 ELD
<br />ATTN: DC~UGI_4S SHAW _ _ .~._.-.__._~- -
<br />~
<br />{ INSVHeA c t
<br />C~iAMC3ND BAI{, CA 91785 INSURER 0. ~ _.__
<br />._.~ ~_
<br />I - _., ~~
<br />IN5UFtEP E I
<br />COVERAGES
<br />TWE POLIOIES OP INSURANCE L,I$TED BELOW HAVE SEEN ISSUED TQ THE INSURED NAMEil A6OVC FOR THE rOLICY PERIOD INOIGATtR. nv+~vl I n3lnrvu~nu
<br />NY CONTRACT OR OTWER 06CUMENT YVlTH RESPECT TU WMICM TMIS C~RTR=ICATE MAY B!: ISSUED OR
<br />OF
<br />IT
<br />C
<br />U
<br />I
<br />A
<br />OPIU
<br />N
<br />ANY REQUIREMENT, 'ERI'~l (~R
<br />b?AY PER7P,IN. THa' !NSURAN~.E A~FORpE[S BY TWE PbliC1ES GESCRISED WEREIN 15 SUBJECT ?TJ tiLL TriE TEid
<br />POLICIES AyGF~E3AZ'~ L!1N1T5 SI'iCJWN MAY' MAVE SEEN RE6UCEi7 BY PAID C!.A!M5, MS. EXCLUSIONS AND OONpITIONS dK ~Urti
<br />~ .-
<br />_
<br />' ~7'~PgI
<br />IC~Y EFP~x~GTiYP ' POUCY EXPiFtATiON
<br />....
<br />-
<br />-' UTArTB
<br />,
<br />iM$H AL7C
<br />PQUCYNUMdf.R ! ~
<br />~ ,_...-----
<br />~
<br />7VPEOFINS"I a~u
<br />~
<br />r
<br />~
<br />.
<br />I EACH GCCUNPF'r;Cc S 1.000,000_-___-
<br />I gENERAL LIABIL~Tf
<br />1 ! LSx~T,~T6RL-'RTE6'-""-
<br />QOQ
<br />s iQO
<br />'
<br />, 7(! CCMMERCIALOENEAaLIJASIL~TY i 1SOE006420 6/912007 61'JF2000 ~
<br />' __.
<br />,
<br />,P'REMiB~$jEacccurencdt~,
<br />1 ~ ~ CLAMS ntADE ~I OL4UR ~ ~
<br />~ rdCG CxP fAry nna PaZan) S 5,000 _ -
<br />A
<br />I
<br />a PERSONAL 8 AON RNJURY ,I 5 1,000,000_
<br />f
<br />J I ALAGGREOATE ! 3 i~OQO,OOO.~-y,_
<br />GENER
<br />' _
<br />i a WNG.LUOED .~~
<br />PRODUCTS • COMRroP Ac~o
<br />il
<br />GCN
<br />L AGGRC(G~ATE LiMrTAPPLI£9 Pf;R;
<br />PI]L~~C'? I A PA^~ i~ lQC ~, I
<br />-- _
<br />...' I
<br /> _.~._---r -- i
<br /> AUT7NOdIlE LIA>BIUTY I
<br />
<br />ANY AUTJ COMkfIN~'J u1hGLL- LIMIT
<br />(Ea accJnenlj
<br />~'___"__-.._-! S
<br />
<br />-_.~.--,-.~.Y
<br /> ~, {
<br />_ A.L Ob'VN66 AUTOS ~,
<br />' 80bILY INJUR"
<br />(RS! petsan) y ~•--- _.
<br /> 5CH£[HILE.D r;JTC6
<br />~ htiREQ AUTOS I BUUILY INJLRY I
<br />! ~
<br />I
<br />(par aCLiprMi ~
<br />
<br />-
<br /> -~ --
<br />! ~ s ~ ~PflCPERT' DAMAGe
<br /> I
<br /> v~ ~ ~-~ ~ J - AUTO UNLY - EA ACCIpk NT 3
<br /> RAGE LlABILiTY
<br />I
<br /> + R 7HAN V ~ ALC
<br />"'MIF S J
<br /> Ah;Y AJTO
<br />. .,.-
<br />9 Q
<br />.
<br />I Al!'f4 CNIY'
<br />i ~ ~~ l AOC3 S ___,_..
<br />I ~ ~_~,
<br />
<br />i...__ ' --~~
<br />I LA LiAf}IL1'IY
<br />ESS1UtAflRE6
<br />I
<br />EACH tlOCURRENGE ~ S
<br />,
<br />~
<br />vLAIM:~ tsSADE I
<br />..000R AGyREC..ATE _ ~~
<br />-- -"-^^-r-•-~
<br />_J
<br />=.~ ! S
<br />r 5
<br />f
<br />.°e
<br />~. M1E7ENTIJN t
<br />' WORKeRS COMPET{BATiON ANC
<br />ENPWYERS' LJAAILlTB
<br />/ _ - ---
<br />.
<br />TORY L1MIT6 . .-_
<br />G.L.'OJaCH ACdIDENT T
<br />~
<br />~
<br />ANY ?ROPRIETURlP~RTNKAtExECJTiVL -
<br />~ OFFICERIMEMEEP. EXCLULTCI:y ~ ~~~~•"-"- ^'' --~-----
<br />F.L. 015EA5E • EA EM~LVYEE S
<br />~~, I( Iee, du8fliDe Ur1CtlP • ,. •, .
<br />! 1 E.L. Df3EABE - PCLIGY uMIT' S
<br />' SPECIA.' PR^J'VIS OIJS z~tav
<br />.
<br />y
<br />_ _ _
<br />~
<br />. eaiJ ~..i. ~. .. ..
<br />UTHER
<br />{
<br />I _ _
<br />OE5CRIPTiON OF OPERATIONS! t,.pCATTtlNR i VE.NICLES f EXCLLiSIONS ADDED qY ENOCRSENEHT /SPECIAL PRLV{SIGNS
<br />..-...-'_
<br />
<br />I
<br />,'+Cd'TI CIPATC VI~i e1CEC 11 Nfie*innai Inclrr'r~A C:aNCFLt11TION
<br />~'
<br />„yrV"Y~~^ 9M4^ULO ANY OF THE ABOVE OESCRI@ED pQIJClt:B BE CANCELLED BEF00.8 THH EXAIRA.TICN
<br />~
<br />r..lTl" OF SANTA ANA
<br />3C4
<br />WRITTEIJ
<br />pTTN• SGT. 9VlARTY SHIREY DAYS
<br />UArE THkftEOE, THE rfiSVING INSURER YAi_l ENDEAVOR 70 MAIL
<br />60 CIVIC CENTER Pt,.A7„A, RM 97 ubTICc ?O 7HE CEriTIPICATE NOLCER kAN1ED Tc iME LEFT, FIU7 rAILURE TO o0 SO SI,ALL
<br />P.O. BOR 1981 IM'PASE 40 QBLIGATIOH Oft LIA@ILIT1' pP ANY KIND UPON YHc itJ5UR8R, fT8 AC:ENTS DR
<br />S.hNTA ANA, CA 92702- _~
<br />r~EPRESENraslvfs-
<br />~.~
<br />I _
<br />AUTNgR12ED 0.EYRESE1uTATIVE ~
<br />~.
<br />AeoRO z5 (zoalrae) CIVIC Gert# 1 IiQIQe1711 Qa~RCVKU riVttT"~AIVrv ~avp
<br />
|