Laserfiche WebLink
HVVKU CERTIFICATE OF LIABILITY INSURANCE DA o ze2009 <br />M <br />PRODUCER Phone: (800) 395 -8075 Fax: (858) 519 -0822 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />FITNESS AND WELLNESS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />380 STEVENS AVENUE, SUITE 206 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />SOLANA BEACH CA 92075 1 ALTER THE COVERAGE AFFORDED BY THE POLICIES RFI nW <br />INSURERS AFFORDING COVERAGE � NAIC # <br />INSURED INSURER A'. Ph_ila_d_elphia Indemnity Insurance Company <br />TIN <br />MAR ATE ES INSURER B <br />DBA DO <br />MAR KARATE KIAI <br />12692 RANCHERO WAY INSURERC: <br />GARDEN GROVE CA 92843 INSURER. D: <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 CLAMS. <br />NSA <br />LTI <br />LTR <br />AOD <br />INSR <br />TYPEOF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE Mr... <br />POLICY EXPOUTION <br />DATE MMIDOIYY <br />LIMITS <br />AUTHORIZED REPRESENTATIVE <br />4 <br />Santa Ana CA 92701 <br />GENERAL LIABILITY <br />PHPK284105 <br />01124/09 <br />OV24/10 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />X COMMERCIAL GENERAL LIABILITY, <br />�� <br />- CLAIMS MADE X OCCUR <br />DAMAGEI5112d D <br />PREMISES Ea 0¢ur¢nm) <br />$ 10O,OOD <br />MED. EXP (Anyone person) <br />$ 2,500 <br />PERSONAL B ADV INJURY <br />$ 1,000,000 <br />A <br />GENERALAGGREGATE <br />S 3,000,000 <br />GENT AGGREGATE LIMIT APPLIES PER. <br />PRODUCTS - COMPIOP AGG <br />$ 3,060,000 <br />PRO - <br />X POLICY JEC LOG <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />',, (Ea acodent) <br />$ <br />ALL OWNED AUTOS <br />BODILY INJURY <br />SCHEDULED AUTOS <br />(Per person) <br />$ <br />HIRED AUTOS <br />NON- OWNEDAUTOS <br />BODILY INJURY <br />(Peraccident) $ <br />FAR <br />O <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE LIABILITY <br />a1f:D <br />AUTO ONLY - EA ACCIDENT <br />$ <br />ANY AUTO <br />A44 <br />OTHER THAN EA ACC <br />$ <br />AUTO ONLY AGO <br />$ <br />EXCESS I UMBRELLA LIABILITY <br />OCCUR CLAIMS MADE <br />0Ut 3 <br />{,1�� ttp100 <br />CW <br />EACH OCCURRENCE <br />AGGREGATE <br />IS <br />$ <br />4 <br />$ <br />DEDUCTIBLE <br />— <br />S <br />RETENTION $ <br />$ <br />WORKERS COMPENSATION ANO <br />EMPLOYERS' LIABILITY <br />' <br />we BTATIY OTHER <br />TORY LIMITS <br />E.L. EACH ACCIDENT <br />-- <br />$ <br />ANYPROPRIETORIPARTNDED? CIITIYE <br />.L DI$EA$E -EA EMPLOYEE <br />OFFICER/MEMBER EXCLUDED? <br />'E <br />$ <br />Use , describe under <br />SPECIAL PROVISIONS Wow <br />I <br />E.L. DISEASE�POUCY LIMIT <br />$ !� <br />I OTHER: <br />-7 <br />— <br />r-T <br />c. <br />DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br />SEE SUPPLEMENTAL CERTIFICATE INFORMATION <br />rtwy:auyr.FnEy:r•1u)y: •raarNyvu•T� <br />ACORD 25 (2001108) Certificate # 87489 © ACORD CORPORATION 1988 <br />e J k <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVORTO MAIL 10 DAYS <br />WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUTFAILURE <br />The City of Santa Ana, Its Officers, <br />TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, <br />employees, agents and volunteers <br />IT'S AGENTS OR REPRESENTATIVES. <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />4 <br />Santa Ana CA 92701 <br />Attention: <br />Jeffrey E. Frick, C/EO <br />ACORD 25 (2001108) Certificate # 87489 © ACORD CORPORATION 1988 <br />e J k <br />