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nr i i~.,~-~e~eni_s 1.5 ~ ~ l I Ht C:HMtiUll ! RN FAMILY 714 571 1974 F' . 02/U,'~ <br />Ar ~22F~D,~ CERTIFICATE OF LIABILITY INSURANCE o3io9~iaos <br />~AOOUCI:A (714)838-1912 FAX (714)838-7568 <br />lake Insurance Agency <br />13891 New ort Ave. , Suite 285 <br />p THIS CERYIFlCATE IS 1S$UED AS A MATTER OF INFORMATION <br />ONLY AND CONFER8 NO RIGHTS UPON THE CER7IFICATE <br />HOLDER. THt9 CZ:RTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTLR THE COVERAGE AFFORDED 8Y THlS PO[,ICIES BELOW. <br />Lic if~07474~3 A-2008-069-09 <br />Tustin , CA 92780 <br />1NStIRERS AFFORDING COVERAGS <br />NAIL # <br />INSUrteo Cambodian Family w;;luAEak Philadelphia Ind. Tns. Co. <br />1111 East Wakeham Avenue INSURERS: Phila~del hie Insuaance Co. <br />Suite E 1NSURSac: K. Freemzll/Philadel hie Ind. <br />Santa Ana, CA 92705 ulna. <br /> YJ9URER ~ <br />COVERAGES <br />7HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMED ABOVE FORTHE POLICY PERIOD INDICATED. NQTWITH&TANDINd <br />ANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUfa OR <br />MAY PERTAIN, THE INSURANCE AFFQRDED BY THE POLIpES DESCRIBED H£REIAi IS 5U8JECT TO ALL THE TERMS, E%GLU$fONS AND CONDITIONS OF SUCH <br />POLICIES AGGREGATE LIMITS SHOWN MAY HAVE 6EEN REDUCIA BYPAID CLAIIYtB. <br />tN9A D' TYPE OFRISURANCE DOLICYR!UM~FR P EFFECTIVE PO P 71011 LIAOTS <br /> c>:NERaLLU.enaTY PJiPK290aa4 03/09/2008 03/09/009 EACH OCCURRENCE s X,000.00 <br /> X COMMlRCtAL GENERAL LWRITY DANAfiE TO RENTED i ZQa, Q0 <br /> CLAUA6 MADE ~ OCCUR MEO EXP IAnYaIO o+rsor¢ t S 00 <br />q PERSONAL a ADV INJURY : 1 000 00 <br /> GENEpN.ASGREGATE s 3,000 00 <br /> 13EN1AGGREGATELIMpTAPPLIEaPEA: PROOUC78-C01+1P10PAOO f ]. OQQ QQQ <br /> POLICY JET LOC <br /> AUTORtoeILE LtA8LL1TY <br />ANYAUro PHPK290824 03/09ja008 03/09/2009 coM81NED SINGLE LIMfT <br />~"od°sn11 <br />i 1 000 00 <br /> ALL OWNED AUTOS OODILY MLIUAY <br />C <br /> SCHEDULED AUTOS <br />(PE~pMO~) <br />A X HIRED AUTOS BODILY INJURY <br />_ <br /> Jt NON.OWNfiO AUTOS (PMaa1QMt) <br /> PROPERTY OA1A+tGE S <br /> (Paraaad+nU <br /> u1MOE !!ABILITY AUTO ONLY • EAACCfOENT i <br /> rNr AUTO oTH&a THAN ~ Acc a <br /> AUT40NLV. AGG t <br /> ExCESSAN1iAELLA WIBIUTY EAG11 OCCUARENOE i <br />r <br /> OCCUR ~ CLABAS MADE AGGREGATE i <br /> _ <br /> DEDUCTIBLE , f <br /> RETENTION i . <br />.. ~ ,. % "] . _ <br /> WORKERS COIi(PEN9AT70N ANO G ^_~~ <br />w _ - . -. ~.~ -~ WC ~TATII• ~~ <br /> EMPLOYERS' LViBIUTY <br />ANY PAOPRIETORIPARTMERtEXECUTN£ E.L.EACMAGCIDEN7 3 <br /> OFFICEA/NEMBERE%CLUDED? `-` '?' ' <br />Et. OWEASE • EA EMPLDYEE <br />i <br /> It ~ deseADa uMe, <br />6~FrfULL PROVISION& 6dow <br />E.L. DISEASE • POLICY LlINIT <br />i <br /> DINER <br />DFSCRtPTK1N OF OPERATION f LOCATION!! VEfAC1.6E J iXCIUilDNB RODEO YY EN EI16MT /S PADIMSION= <br />Except 10 days for non payment of premium. Enlp-!oyes D shonesty 5200,OOOjS2,500 Ded. <br />ity of Santa Ana is named additional insured per contract witfi named insured. <br />=10 days Natice of Cancellation shall be given in the event of noq-payment of premium. <br />The City Of Santa Ana; Its Officers,Employees <br />Agents, representatives <br />20 Civic Center Plaza (M-30~ <br />aHOULOI-HYOP TILE ABDVE oESC1uBED rDUCIO BE CAMt~LLED sEFORE TI{E <br />EKPtMTIONpATETFIEREOF,THEWBUUIGBRIIRERiMLfy `~MNit <br />~O* 06Y! WRTREN NOTICE TO THE CERTB7GITE MOLDER NAMED TO THE LEFT, <br />I;tamc~cxx <br />Santa Ana, CA 92x05 <br />AcORO 26 (2oovoe) FAX: (714) 571-1974 ®ACORD CORPORATION 1988 <br />