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CERTIFICATE OF LIABILITY INSURANCE OTEMPL CI OS/OS/OB <br />OF INFORMATION <br />~ <br />acoRD THIS CERTIFICATE IS ISSUED AS A MATTER TE <br /> CONFERS NO RIGHTS UPON THE C ERTIFICA <br />PRODUCER ONLY AND <br />ERTIFICATE DOES NOT AMEN D, EXTEND OR <br />Chapman & Associates HOLDER. THIS C <br />RAGE AFFORDED BY THE POLICIES BELOW. <br />22024 ALTER THE COVE <br />License #05 <br />p. o. Box 5455 NAIC # <br />~ <br />Pasadena CA 91117-04 5 5 INSURERS AFFORDING COVERAGE _ __ - <br />626-405-8031 Fax: 626-405-0585 <br />Phone: - <br />uxeo <br />ixsuPER a SCIF-Santa Ana <br /> <br />Templc Calvar io CoEmnuni ty Deve NsePERD -- -'- ~ <br />2617 West 5th St <br />Santa Ana CA 92703 suRERE <br />COVERAGES <br />nxG <br />O <br />E <br />AmEO <br />u <br />rXE POUCes of ~nsLP+ucE USreo 6BLOn H..E <br />PESVea ro wN C <br />uMErvr <br />eRO <br />a *v.c SE ISSUeo oP <br />ERiiPmnrE UP <br />n rxa <br />-aR Om <br />C <br />..RECwR <br />nes GESCR~BEO HERem is sER,EC*-o.,. rNE rePMS E.cwslons+uL COxmnoxs oP SUCH <br />A <br />~ <br />e <br />rtiEPUl <br />PwaGEO6r <br />wsuPnxcE <br />x. rH <br />P <br />ESipcGiEC/.rEUMirs sHCWN MP. HPV[PEEN PECUCEC BV PIIC CU'MS <br />' <br />- poLICY E,EEtiIVE OLILY E(PIPPLION <br />P <br />X <br />-~ - <br />r OAiE IN WDOIYVI <br />PiE IMMNDIYVI <br />000,400 <br />5 1 <br />iYPf OEIHSVRRN[E En<H OCCVRPENCE __ <br />, <br /> .LGE LO RE LEO S 100,000 <br />OEMERPL UPBILIiY 02/08/08 02/08/09 PREMises,E. ~~.•=•I <br />200817088NP0 <br />A X co,wIERGAL CExERPLU eEIF' MEO ExP I+•r ~. v^..m~ s 10, 000 <br />curers WOE L%ocCUR ~ ERSOWLE wmmPY <br />P s 1,000,000 <br />~ 000 <br />000 <br />s 2 <br />i <br />GENEP.LPGORECPPE <br />, <br />, <br />- <br /> - <br />PRaoucrs oMPwv ncc s 1,000,000_ <br /> ccFECPiEUMIr/.PPUES PER <br /> vno- La <br />alcv <br />Em <br /> v <br />, <oMB~xeG SmcLE UM~R s 1000000 <br />ON.GBILE UAMIURr 02/06/08 02/08/09 leacewl <br />rcuRO <br />Px 200817088NP0 <br />A 60CILV,WVRV ~ L <br />' LL RVNEC PUL05 <br />sCHEOVLEO PUiOB - <br />IPp P.~rwV <br />BOChYIWURV _ <br /> <br />I <br />F <br /> <br />NipEC PVioS <br />X noN.G.vXED PU*os <br />IPx cwmV - <br /> <br />ROPERn CAW GE <br />P -I <br />I <br />- -- <br />F <br />-- IPa z:o- 0 <br /> o Cnly~ER ACCICFV' s ~~ <br />T' <br />cE WBRI ~NEPrnnN EAP-L S __ <br /> O <br />P i00M1LV PGG <br /> E.CH OCCUPPExCE 5 - <br />EaCE55NMBREILA UABIMiY MSM <br />I~-~ ~ c AGE <br />6CVR PGOPEG}rE <br /> <br />~ L ~_ - <br />~ _ <br />. <br />_ <br />~, <br />I DEGVCTGLE Y 3.~ <br />- <br />I ' <br />~~~--111 REIENiION s ~ WC SL.1rLL <br />X roR.uurts - <br />WORKERS COMPExsAilox PXG pl/pl/08 01/01/09 EL E.cH nccmExP s 1000000 _ - <br />EN.LOrEPr u.RRl*Y 181617 8 0 8 <br />GrsEASE~E. EMPLOYEE s 1000000 <br />6L <br />D PROPRIEroP,PARrn6RrExECUnvE . <br />OPPicERwESeER EKCLUCEDt L.OisESSE. POU: s 1000000 <br /> <br />s~ECIAL PPOVlsioxs o-ie. <br />OLMER <br />GEECRIPPOX Of OPERPTON51 LOCALIONS I VEXICLE51 EFL W SANS AOOEO RY EHOOREEMEMi I EPECIPL PROVISIONS <br />Evidence of coverage. 10 days notice of cancellation for non-payment of <br />premium. ~ ~ / <br />- /l-i'-'C~~-C~ //~ <br />CERTIFICATE <br />City of Santa Ana <br />1000 E. Santa Ana Slvd., #200 <br />Santa Ana, CA 92701 <br />CANCELLATION <br />CTYSAN9 EMOVLY AMY OF iXE ABOVE GESCRIBEO POYGES RE CANCELLED RE50RE tNE ERPtlLAiIOM yS WRIriEM <br />OPiE FMEREO S.iME I34YINOIXSUREP WILL EYYEAIR"YO NAR 30 <br />OFICE i0 ME CERFIEICAiE MOLDER NAMED iO iXE 1EEt.5W'WMMRCMlOSWTN'R <br />1988 <br />