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<br />ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DOIYVYY) <br /> 02120/2008 <br />PRODUCER Phone: (BOO) 747.9573 Fax: (303) 422.1276 THIS CERTIfiCATE IS ISSUED AS A MATTER OF INFORMATION <br />The Camp Team ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />7615 W. 38Th Avenue, Unit B.109 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Wheat Ridge CO 80033 ALTER THE COVEIlAGE AFFORDED BY THE POLICIES BELOW, <br /> __/1/- ~_o 9 7 -:. J 3,)./__ INSURERS AFFORDING COVERAGE NAIC# <br />-"-- -_. __._______._____0__.._ .-- 1---- <br />INSURED INSURER A: Capitol Indemnity Ins: Corp .-.--.---- !-. <br />Asics Southern Cali10mla Wrestling Academy I Santa Ana I-'NSURER B: --'. <br />Wolfpack Freestyle f'NSURER-C: . ----t-- <br />1737 Pitcairn Dr. - <br />Costa Mesa, CA 92626 ' INSURER D: .- <br /> _m <br /> i INSURER E: <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <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 />,_ AOOl TYPE OF INSURANCE POLICY NUMBER Prfi;~~~~';~~)E P~~: ~~~~~ WIlTS <br />LT" ...., <br /> GENERAL LIABILITY CS00218051 03101/2008 03101/2009 EACH OCCURRENCE ~ 1,000,000 <br />I X AMAGE TO RENTED f$ 100,000 <br /> COMMERCIAL GENERAL LIABILITY REt.lISES (Ea OI;(;unencel <br /> I CLAIMS MADE I X I OCCUR MED. EXP (Anyon. person) r> 5,000 <br />A X tNC ATHLETIC PARTICIPANTS ERSONAL & ADV INJURY ~ 1,000,000 <br /> 3ENERAL AGGREGATE 2,000,000 <br /> RODUCTS.COMP/OP AGG. 1,000,000 <br />i POLIC1 I PRO. I I LOC <br /> JECT <br />! ~UTOMOeILE LIABILITY PoMBINED SI NGLE LIMIT <br /> ANY AUTO Ea acddenl) <br />I ALL OWNED AUTOS eOOIL Y INJURY -) L <br /> SCHEDULED AUTOS Per person) J"'-' f-, <br /> HIRED AUTOS , ~ .... .'" <br /> NON.OWNED AUTOS BODILY INJURY C,O; <br /> Por accidenl) <br />I -, <br />I ROPERTY DAMAGE <br /> Per accident) ;.,,", <br /> GARAGE LIABILITY . UTO ONLY - EA ACCIDENT <br /> ANY AUTO I THER THAN EAACC ~,.. ~ <br /> I LITO ONLY: AGG $ <br /> ~XCESS I UMBRELLA LIABILITY ACH OCCURRENCE $ Cf.? <br />I I OCCUR I I CLAIMS MADE GGREGATE ". - $ \ -... <br />, .- "J <br /> lY <br /> DEDUCTIBLE 1> <br /> RETENTION $ S <br /> ~-- .- I~~RS:A~~~~ I I nM" <br />~~:t~~~;P~::,~~~TKlN AND <br />JANv PROPRIETOR/PARTNERlEXECUTtve .L. EACH ACCIDENT <br />pFFICERillEMIl~R EXCLUDED? .L. OISEASE.EA EMPlOYEE ~ <br />~f yea, describe under <br />~PECI"'L PROVISIONS below ".L DISEASE. POLICY LIMIT ~ <br />pTHER: <br /> -.---- <br />DESCRIPTION OF OPERATlONS/lOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTSISPECIAl PROVISIONS <br />Wrestling I CA <br />Policy Deductibles: $0.00 per each bodily injury 1$500.00 pcr each properly damage claim. <br />Additicnallnsured(s): Cily of Santa Ana, its otlicers. agents, employees, representatives, and volunteers, All participants. staff and facilities as scheduled <br />with the company are added as addillonal insured in regards to the operations of the insured. <br />This insurance is primary and non-contributory to any other insurance held by the insured in regards to the operations of the insured. <br /> <br />CERTIFICATE HOLDER <br />r City Of Santa Ana - <br />, 20 Civic Cenler Plaza <br />! Santa Ana, CA 92702 <br />I <br /> <br />i;yp I;'~-,_-;?L, 1/ L <br />I Attentlon~___H/':?\':__ (~_ h_ <br /> <br />CANCELLATION <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL !.tAIL 30 DAYS WRITTEN NOTICE TO THE <br />CERTIFICATE HOLDER NAMED TO THE LEFT. <br /> <br />...!^~~""'-~~~~ ':"~~~_.. <br /> <br />ACORD 2S (2001/08) <br /> <br />@ ACORD CORPORATION 1988 <br /> <br />