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�A.•OR� TM DATE (MMIODIYWY) <br />CERTIFICATE OF LIABILITY INSURANCE 10/1512OD8 <br />PRODUCER Pnone 18M)395e ®S Fax. (059) 51 a -0e42 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 ALTER THE COVERAGE AFFORDED BY THE EOLICIES BELOW, <br />INSURED <br />FRANK ALANIZ <br />2234 SOUTH TOWNER ST <br />SANTA ANA CA 92707 <br />INSURERS AFFORDING COVERAGE <br />Agency LiCp_0377645 <br />NSURER A. Philadelphia Indemnity Insurance Company <br />INSURER E: <br />INSURER C- <br />INSURER D. <br />INSURER E: <br />NAIC # <br />V V v -- <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TC THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NCIW'THSTANDING <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE-1 HE <br />ANY REQUIREMENT, TERM CR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT <br />TOWW -H THIS CERTIFICATE MAY BE ISSLED OR <br />MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL <br />THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />AGENTS OR REPRESENTATIVES. <br />SANTA ANA CA 92701 <br />ADD'L YPE OFINSURANCE POLICY NUMBER EFFECTNE I POLICY EXPIRATION LIMITS <br />INSR GATE i1W0 DATE MEW <br />Attention'. <br />rR GENERAL LIABILITY PHPK284105 10/19108 <br />10119109 <br />EACH OCCURRENCE <br />IS <br />1,000,000 <br />DAMAGE TO RENTED <br />PREMISES R NNED al <br />$ <br />1DO,000 <br />I X COMMERCIAL GENERAL LIABILITY <br />MED. EXP (Any one person) <br />$ <br />2,500 <br />CLAIMS MADE n OCCUR <br />PERSONAL& ADV INJURY <br />$ <br />1,000,000 <br />A <br />$ <br />3,000,600 <br />GENERAL AGGREGATE <br />PROD =- CCCMP /OP AGG <br />$ <br />3,066,666 <br />�G�ENT�G GR EGATE LIMB APPLIES PER. <br />POLICY I PRO <br />LOC <br />AUTOMOBILE LIABILITY <br />'COMBINED SINGLE LIMIT <br />$ <br />ANY AUTO I <br />(Ea acCWent) <br />�nBODILY INJURY <br />ALL OWKFO AUTOS <br />--J-�� <br />(Per person) <br />$ <br />I-- SCHEDULEDAUTOS I <br />-- <br />BODILY INJURY <br />$ <br />HIRED AUTOS <br />. NON OWNED AUTOS <br />(Per aGCident) <br />- <br />PROPERTY DAMAGE <br />S <br />Per accldenll <br />GARAGE LIABILITY <br />AUTO ONLY • EA ACCIDENT <br />$ <br />I J ANY AUTO <br />OTHER 7 FA ACC <br />$ <br />AUTO ONLY. AGG <br />S <br />EXCESS I UMBRELLA LIABILITY <br />/ - ` <br />EACH OCCURRENCE <br />$ <br />'AGGREGATE <br />$ <br />OCCUR CLAIMS MADE <br />L. r <br />/ <br />I <br />S . <br />DEDUCTIBLE <br />_ _ <br />T <br />S <br />RETENTION $ <br />I <br />WC STATIC OTHER <br />I WORKERS COMPENSATION AND <br />ToRV uwTs <br />E.L. EACH ACCIDENT ;5 <br />EM PLOYERS' LIABILITY <br />AMY PROPRETOPUFAWNEWEXECUTARi <br />OFFICt—EMBEA RXGLL --1 <br />e6 DISEASE -EA EMPLOYEE S <br />°^w� <br />E.L. DISEASE- POLICY LIMIT .$ <br />$PEC LPRQ <br />SPECIAL PROVRIONS W qw <br />OTHER: <br />DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br />It is understood and agreed that the following entity Is added as an additional insured but only as respects the operations of the named Insured <br />except that liability resulting from the additional Insureds sole negligence. <br />ACORD 25 (2001/08) Certlhcate8 15224ti l91MLiVRUVVRrVRw pan. ,moo <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE-1 HE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENOEAVOR TO MAIL 10 DAYS <br />WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO <br />THE CITY OF SANTA ANA <br />DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS <br />20 CIVIC CENTER PLAZA <br />AGENTS OR REPRESENTATIVES. <br />SANTA ANA CA 92701 <br />AUTHORIZED REPRESENTATIVE /Jeffrey g C <br />Attention'. <br />E. Frick, CEO <br />ACORD 25 (2001/08) Certlhcate8 15224ti l91MLiVRUVVRrVRw pan. ,moo <br />