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ACORD I DATE (MRVOD/YYYYI <br />TM. CERTIFICATE OF LIABILITY INSURANCE 1�J0sre0oa <br />FITNESS AND WELLNESS <br />380 STEVENS AVENUE, SURE 206 <br />SOLANA BEACH CA 92075 <br />INSURED <br />CHOC V. LE <br />4 FABRIANO <br />IRVINE CA 92620.2576 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />INSURERS AFFORDING COVERAGE 1 NAIC # <br />Insurance <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERM INDICATED, NGTVnTISTANDING <br />ANY REGUIREMENT, 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 />POLICES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />EyRN <br />Lm <br />Pppt <br />TYPEOFINSURANCE <br />POLICY NUMBER <br />POLCYEFFECTNE <br />DATBx <br />POLIGYEUmWTEIN <br />DAnimmucrn <br />LIMITS <br />A <br />GENERALLIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLFIMSMADEO OCCUR <br />PHPK284105 <br />12/17/08 <br />12I17f09 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DMMOE TO RENn:O <br />PREMISE$ ENTEDro <br />$ 1D0,000 <br />MED. EXP(my we Person) <br />$ 2,500 <br />PERSONALS ADV INJURY <br />$ 1.000,000 <br />GENERALAGGREGATE <br />$ 3,000,000 <br />G£N'L AGGREGATE LIMIT APPLIES PER <br />X POLICY JE TT LOCH <br />PRODUCMCOMPIOP AGO. <br />$ 3,000,000 <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALLOWNEDAUTO$ <br />SCHEDULED AUTOS <br />HREDAUTOS <br />NON-0CWNEDAUTOS <br />COMBINED SINGLE LIMIT <br />(EiI=idenl) <br />S <br />SCOLLYINJURY <br />(Perpersonl <br />S <br />SODLYINJURY <br />(Peram4ent) <br />$ <br />PROPERTYDAMAGE <br />(PerI=id9-1 <br />$ <br />GARAGE LIABII/TY <br />ANYAUTO <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHER THAN EA ACC <br />AUTOONLY: AGG <br />$ <br />$ <br />EXCESSfUMSRELULIABILITY <br />OCCUR �CWMS MADE <br />DETECTIBLE <br />RETENTION 8 <br />- <br />1`r <br />''-P / <br />_ <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />$ <br />g <br />WORHERSCOMPENSATIONAND <br />EMPLOYERS' LIA&DTY <br />AXYPROPRETOENARTNEWEItECOFNE <br />OFFICERxRXIeXA e%CLIMFOt <br />Yx SPECIAL IALP Fwd,r <br />PROVaa1N8 Mbw <br />IY /11f,:; ,�„V <br />WC STAT <br />TONYEWT$ OTHER <br />E.L. EACH ACCIDENT <br />S <br />El- DISEASE -EA EMPLOYEE <br />E <br />E.L. DISEASE -POLICY LIMIT <br />E <br />OTHER: <br />DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS <br />SEE SUPPLEMENTAL CERTIFICATE INFORMATION <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORETNE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL W DAYS <br />WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO <br />COmmunity Redevelopment Agency <br />DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY NND UPON THE INSURER, II'S <br />of the City Of Santa Ana <br />AGENTS OR REPRESENTATIVES. <br />20 Civic Center Plaza (M-25) <br />AUTHOJZED REPRESENTATIVE <br />Santa Ana CA 92701 <br />Cel <br />• <br />Attention: <br />Jeffrey E. Frick, CEO <br />ACORD 26(2001/DB) Certificate# 85130 0 ACORD CORPORATION 11988 <br />