TORRES, MARTIN 6E - 2008 - Laserfiche WebLink

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Iv- Zpr) 3 -L�,9¢ DATE(MMOONYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE PRODUCER pFMe: (SOD) 395-80'5 Fax. (6581518-0BYZ THIS CERTIFICATE IS R 0 111 NITS UPON THE CE ISSUED AS A MATTER OF 'il FITNESS AND WELLNESS HOLDER DTZCERTIFICATE GOES NOT AMEND 380 STEVENS AVENUE, SUITE 205 ALTER THE COVERA AFFORDED BY THE POU SOLANA BEACH CA 92075 INSURERS AFFORDING COVERAGE POLICES OF INSURANCE LISTED BELUW rwvc TERM OR CONDITION OF ANY MBUKLIN n: INSURED INSURER B: MARTIN TORRES WOUIREMENT, PERTAIN. THE INSURANCE AFFORDED BY MAY HAVE DBA KARATE DO KIAI INSURER C: 12592 RANCHERO WAY INSURER D: GARDEN GROVE CA 92843 IusuaER E: POLICES OF INSURANCE LISTED BELUW rwvc TERM OR CONDITION OF ANY m =�. CONTRACT OR OTHER DOCUMENT WITH RESPECT TO ALL 70 WHICH THE TERMS, EXCLUSIONS AND CONDITIONS d WOUIREMENT, PERTAIN. THE INSURANCE AFFORDED BY MAY HAVE THE POLICIES DESCRIBED HEREIN BEEN REDUCED BY PAID "'MS. IS SUBJECT _ ICIES. AGGREGATE LIMITS SHOWN PGLLL'1'6iiEC1NE POUeVY4TNW LMrrS x�isA TYPE OF Wa11NANCE POLICY NUYBER 01!26108 01124109 EACHOCCURRENCE nilAD¢TO REHTED GENERAL LIABILITY PHPK215378 AGGREGATE X i COMMERCIAL GENERAL LIABILITY PPEYMES Eeaaamu FED. E)IP (MY one perem) C W MS MADE OCCUR LE N 4 PERSONAL a AM INJURY — Y1'DfTION AND EMPLOYERS'UABILITY GENERAL AGGREGATE EL. EACH ACCIDENT pR0007 GOMPrOP AGG. IE.L.DISEASE-EAEMPLDYEE E UMIT APPUES PER: AMY VRPRIIEipYPAATxEMEYEDYnvE OFFICEWIIYaER IXCWOFD'I PRO- LOC JECT 40�LOWNWAUTOS E �,� COMBINED SINGLE LIMIT MUTY '.. (Ea actl m) - BODILY INJURY DAUTOS i IPw ee .O SCHEDIAEDAUTOS HIDED AUTOB 'BODILY INJUR Y (PeramiDee) NON-OWNED AUTOS _ I PROPERTY DAMAGE rvr.mderel OR NAIC a 1 DESCRIPTION OF OPERATIONS ILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS It is understood and agreed that the following entity is added as an additional Insured but only as respeets the operations of the named Insured except that liability resulting from the additional insureds sole negligence. Additional Insured Endorsement is Effective: 1124108 SEE ATTACHED ADDITIONAL INSURED ENDORSEMENT *CG 20 2511 85 The City of Banta Ana, its otresra, employees, agents and representatives. P.O. Box 1988 M•23 Santa Ana CA 92792 Attention: ACORD 25 (2001108) Certificate a SHOULD ANY OF THE ABOVE DE: EXPIRATION DATE THEREOF, THE WRITTEN NOTICE TO THE CERTIF TO DO SO BNALL IMPOSE NO OBLIC ITS AGENTS OR REPRESENTATIVE! BE DAYS NAMED TO THE LEFT. BU I YA1LURC ITV OF ANY VINO UPON THE WSURER Ir cr/ 7ez� y E. Frick, CEO ACORD CORPORATION 1988 LIABILITY _._. OTHERTHAN AUTOONLY: EACH OCCURRENCELLAlMMLT' �CUINS MACE tE AGGREGATE LE N 4 Y1'DfTION AND EMPLOYERS'UABILITY �{� L f/Z iOxv LWrts EL. EACH ACCIDENT 4 IE.L.DISEASE-EAEMPLDYEE 4 AMY VRPRIIEipYPAATxEMEYEDYnvE OFFICEWIIYaER IXCWOFD'I - El DISFASEPOLICY LIMIT E �,� DESCRIPTION OF OPERATIONS ILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS It is understood and agreed that the following entity is added as an additional Insured but only as respeets the operations of the named Insured except that liability resulting from the additional insureds sole negligence. Additional Insured Endorsement is Effective: 1124108 SEE ATTACHED ADDITIONAL INSURED ENDORSEMENT *CG 20 2511 85 The City of Banta Ana, its otresra, employees, agents and representatives. P.O. Box 1988 M•23 Santa Ana CA 92792 Attention: ACORD 25 (2001108) Certificate a SHOULD ANY OF THE ABOVE DE: EXPIRATION DATE THEREOF, THE WRITTEN NOTICE TO THE CERTIF TO DO SO BNALL IMPOSE NO OBLIC ITS AGENTS OR REPRESENTATIVE! BE DAYS NAMED TO THE LEFT. BU I YA1LURC ITV OF ANY VINO UPON THE WSURER Ir cr/ 7ez� y E. Frick, CEO ACORD CORPORATION 1988