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<br />: . L . 7 2' i'O <br />, ~ l', ,I, ,.II) / <br />----., , <br />ACORD8 <br />l ..___' <br />I PAODucm <br /> <br />4. 18 :''1 <br />, JII'I, <br /> <br />M~RTEN2 IN;U~ANCi AGi~CY <br /> <br />\'.. <br /> <br />7511(; <br /> <br />~' . <br /> <br />CERTIFICATE OF LIABILITY INSURANCE I VA"iMM""'",", <br />2/17/2009 <br />I THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS C~RTI~ICATE DOES NOT AMEND, EXT~ND OR <br />ALTER THE COVERAGE AFFOROED BY THE POLICIES BELOW. <br />, <br /> <br />MERTENS INSURANCE AGENCY <br />715 ZION ST <br />NEVADA CITY, CA 95959 <br />15301265-0621 <br />IN","CD CAROL LOTT <br />LL CONSULTING <br />4209 N 45TH ST <br />PHOENIX, AZ 85018 <br />, <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED 8ELOW IiAVF RFFN ISSUED TO THE INSURED NAMED ABOVE rOf{ IHF POLICY PERICJD rN:J1CATED. NOTWrTHSTAN()[NG <br />ANY REQUIREMENT, TERM Of( CONOITIQN OF ANY CONTRACT OR OTHER DOCUMENT WITH' HESi=tF.CT TO WHICH THIS ::ERTrF1CATE MAY oe ISSUED OR <br />MAY PEH1AltJ, lHE INSURANCE AFFORDED BYTHE POLJCIES DESCRIBED HEREIN IS SUBJlC'l TQ ALL THE TERMS, EXClL'SIONS AND CONlJl f'tONFi OF S~jCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REOUC!:.D BY PAID CLAIMS. <br />IN8R 'L ..- POLICY ErFEci"IVE"'OL1CY ~.J(PIR^nt)N <br />L.TR NaRD 1l'PF F IN::; rUIN C POlIt:y NuM8F.R nATC MMIODNYY"Y DATE M 1 YY <br /> <br />COMPAI'''' <br /> <br />I.~SURCR D. <br /> <br />INSu~fR. (: <br /> <br />INSURER 0 <br /> <br />IN$URFR F. <br /> <br />(;E.NFR^I IIllAfllTY <br /> <br />et.Cll '.lccuRnENcE <br />O.RFNT;::n <br />'f'RfJ/II~E5 i:fl' OlXlJrlinc"" <br />MCD D ~ (AllY o"eo ~~ol"!2 <br />PE~SOI'JA.1 A. N)vIN.JlJRY <br />GENER-\~ AGl.;~I:C;AII::. <br />PRonw, Tr. Cm~F'fOr AGG <br /> <br />A <br /> <br />X CGMMeRCIAl GENERAL LIABILITY <br />._~IClA'MSMAL>' [] OCCUR, <br /> <br />02/28/10 <br /> <br />57 SBA AU0614 <br /> <br />02/28/09 <br /> <br /> <br />loe <br /> <br />AU I OMORll I:; IIARlI ITY <br />I ANY AUTO <br />All. O\r'JNF.fI AUTOS <br />SCHEDULED AUTOS <br />HII<En AUTOS <br />NON-OVVNEtl AU' OS <br /> <br />COMCIN[D SINGLE liMn <br />([;I ;l.c<::'d~r!ll <br /> <br />BOO'~'" NJUHv <br />:1:'.., pe ~\!,,) <br /> <br />BODilY INJU~Y <br />. W",r ",~,,_i1eo!ll) <br /> <br />GArv..r..>E lIAB1LIl.... <br />ANYMIT:") <br /> <br />\'RO\JbD <br />;...\' . ~ <br /> <br /> <br />f"'Kf)I-'I:~I't OI\MMF." <br />:r~r ~('''''<1""I't) <br /> <br />AJ)TQ ONl.Y 1:,\ ACCID'7-~T ~ <br /> <br /> <br />, fJl'icK !HAN <br />AUTOCNLY <br /> <br />eXCESS I UMBRELLA LIABILilY <br />.1 UCCUR CI CI.A.IMSMAflF <br /> <br />'nt1 "UOrne <br />Ci\~ " <br /> <br />I;:ACH lCCURRF.Nr.r, <br />AGGRE'.>~T.E <br /> <br />L-I [)FriUr:T1AIr- <br />j RETENTiUN $ <br />WOI1KERS CUMf"'EN5A T IUN <br />AND r::Mf'lOYFRS' llAAlIlTY <br />...N.... ~O~RIE.lo~""'~rNL~.LXLCtoll.'~ <br />OFFICERIMEMBEFl EXCLL'OE07 <br />(MII,,,twtOfyitlNHj <br />~r.~(;:2~~OV:~ONS nr.Jow <br />Q":'HEI1 <br /> <br />"" <br />~ <br /> <br />W::STATJ- <br />--.l.Q ,. <br />Ei.., [^';IIIICCIDEN-:'" <br />tL lll::,~ASF - r-A FMP: t'lYI:C $ <br /> <br />I:.L DltEASE - POLICY Llrtll <br /> <br />DESCRIPTION or O?EI1A-:"IONS ,. LOCA 110"l3 I VI:HICU".S 1I:;>I;t.lll$I(JNl=i ^DD[D OY CNDORSEMENT! SPECIAL f'AUVISIClN$ <br /> <br />~# <br /> <br />, <br />--j <br /> <br />LIMITS <br /> <br />'1.000.000' <br />, 3.00,000 <br />, 10.000 <br />'....1.000, QQ.Q.; <br />, 2 000 000 <br />, 2,000.000 <br /> <br />., <br /> <br />!, <br /> <br />., <br /> <br />FA ACe $ <br />AGt; ':J <br /> <br />~ <br />~_. <br />U1H.' <br />'R <br /> <br />i <br />! <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />COMMUNITY REOE:VELOPMENT AGENCY <br />THE CITY OF SANTA ANA AND THE <br />CITY OF SANTA ANA <br /> <br />OF <br /> <br />$1~t1 ANI' OF THE ABOVE DESCRIBED POLICIES BE (;^NCELL.HI OI::'Ol'lIE THE EXJ'IRATIClN <br />DATE THEfIlEOF. TIlE 1$."lUIffl:; IN~URElI: IMLL :~, I,. .. '" MAIL. 3 0 DAV'!l WRIT'T'EN <br />NonCE TO THE lBI:TIFI{;,UE IltlLI}(" NAMED TO THE L.EFT,MAt-. DO ~O SItll,L.l <br />IMPO$iI! ~t) lJ9l.IGAllON OR l..1ABlLITY OF ANY KIH[l UPON Ttll! IIrISUIIElI:, IT! AGENT8 OR <br /> <br />I ,FAX: 714-647-6549 <br />ACORD25(2009101) <br /> <br />RE"RElENTATIVE5. <br />AUTHORIZED RErREStN l/>.l1VF <br />~" u;.JuJtJ.1P- <br />{I <f;;)1988.2009 ACORD CORPORATION. All rlghls reserved_ <br />The ACORD name and logo are registered rnar'ks of ACORD <br /> <br />ATTN: TERRI <br />