|
08/07/2010 08-43 FAX 80,050109:05
<br />ACGORG INSURANCE SVC'S R00,01/002
<br />. .. . .. .
<br />A
<br />A0010 OY EMOORSEMENMSPECAL IFFRWOWMVI',
<br />Ci ty, Of Santa Ana is namwd an'! Alonal Insluted per, Mxh, bhitI, A
<br />O�WIFJWE HOLDER
<br />el—, ''1 1
<br />AD OM, ONA L IN WIRSO - IN SUArg L E`�'nm R
<br />The City of Santa Arlm
<br />18,2S W Civic centalt�
<br />Santa Ana CA 927,03
<br />attn*, Donna, Schultze
<br />f do
<br />14. IS 71 -42 6 6
<br />SHOULD ANY O?r THE AUME, MCQJM 90 P%cMES UE CANCEL,Lfo
<br />WOM TM, -I, AT*Nj
<br />bATS THEREMPITHE ISSRMR Wjj& 0 YSS WRfT
<br />CPA
<br />NIMAM TO THE C1R17,PcA7m HOOMMAPNED, TO THE LEF�'NIT FftUtFM, To� jDOh go SHALL
<br />L14-
<br />APR AS
<br />A' 0, Y!
<br />n P
<br />.. - .. . .. . .. . .. .
<br />OXESS LIAEOLM
<br />C
<br />OcCUR, CLAIMS MAM,Yil@Amau'MEGATE
<br />00
<br />?1001
<br />OaNtRAL LMfUTY
<br />__j
<br />dllal� , "
<br />Imumuliilwmu�usamuer
<br />CIO"' ERM04I GeNeRAL, LITARUTY
<br />"y, FL U�
<br />CHER
<br />T
<br />IS 0ccCjR
<br />_j TCIMS MAC
<br />-----
<br />Irou
<br />Im -1011,11111, 111 loll, I
<br />CLU 5, 6 4 2 94
<br />.
<br />. . . . . . . . . . . . . . . . . . . . . . . . .
<br />Q-1 EI AOOMENT�
<br />. . .. . ... .... ....
<br />E L 0111181SAS E - EA EWLQYj'j 6
<br />GERLLIMIT APPUES PaFt
<br />ISE
<br />E LD-ABE �- PDUCYLIMIT
<br />OTHER
<br />MON
<br />P %Y
<br />AUT OMOOWE VAMLITY
<br />ANY�A=
<br />ALL MUM AUTOKS
<br />mnzn4uros
<br />z
<br />A0010 OY EMOORSEMENMSPECAL IFFRWOWMVI',
<br />Ci ty, Of Santa Ana is namwd an'! Alonal Insluted per, Mxh, bhitI, A
<br />O�WIFJWE HOLDER
<br />el—, ''1 1
<br />AD OM, ONA L IN WIRSO - IN SUArg L E`�'nm R
<br />The City of Santa Arlm
<br />18,2S W Civic centalt�
<br />Santa Ana CA 927,03
<br />attn*, Donna, Schultze
<br />f do
<br />14. IS 71 -42 6 6
<br />SHOULD ANY O?r THE AUME, MCQJM 90 P%cMES UE CANCEL,Lfo
<br />WOM TM, -I, AT*Nj
<br />bATS THEREMPITHE ISSRMR Wjj& 0 YSS WRfT
<br />CPA
<br />NIMAM TO THE C1R17,PcA7m HOOMMAPNED, TO THE LEF�'NIT FftUtFM, To� jDOh go SHALL
<br />L14-
<br />APR AS
<br />A' 0, Y!
<br />n P
<br />'
<br />OXESS LIAEOLM
<br />C
<br />OcCUR, CLAIMS MAM,Yil@Amau'MEGATE
<br />00
<br />?1001
<br />Il1N1NJNYf111Wiwam
<br />SAOM 0,1017URREMP,
<br />..... .. .. ..
<br />__j
<br />dllal� , "
<br />Imumuliilwmu�usamuer
<br />"y, FL U�
<br />CHER
<br />T
<br />-----
<br />. . . . . . .....
<br />WCkfMM l�':S QJQMM SATIOIN AND
<br />MMKOYORW
<br />Q-1 EI AOOMENT�
<br />. . .. . ... .... ....
<br />E L 0111181SAS E - EA EWLQYj'j 6
<br />ISE
<br />E LD-ABE �- PDUCYLIMIT
<br />OTHER
<br />A0010 OY EMOORSEMENMSPECAL IFFRWOWMVI',
<br />Ci ty, Of Santa Ana is namwd an'! Alonal Insluted per, Mxh, bhitI, A
<br />O�WIFJWE HOLDER
<br />el—, ''1 1
<br />AD OM, ONA L IN WIRSO - IN SUArg L E`�'nm R
<br />The City of Santa Arlm
<br />18,2S W Civic centalt�
<br />Santa Ana CA 927,03
<br />attn*, Donna, Schultze
<br />f do
<br />14. IS 71 -42 6 6
<br />SHOULD ANY O?r THE AUME, MCQJM 90 P%cMES UE CANCEL,Lfo
<br />WOM TM, -I, AT*Nj
<br />bATS THEREMPITHE ISSRMR Wjj& 0 YSS WRfT
<br />CPA
<br />NIMAM TO THE C1R17,PcA7m HOOMMAPNED, TO THE LEF�'NIT FftUtFM, To� jDOh go SHALL
<br />L14-
<br />
|