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N-2007-050-02 <br />A1r1�mm CERTIFICATE OF INSURANCE 02104412009 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />WAFERS INSURANCE SERVICES <br />HOLDER- THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />LICENSE. NO.: 0570726 <br />ALTER THE COVERAGE AFFORDED BY THE: POLICIES BELOW. <br />10061 TALBERT AVE., SUITE 200 <br />COMPANIES AFFORDING COVERAGE <br />4-.--- A <br />FOUNTAIN VALLEY, CA 92708 <br />_ - -- -- - - --- - --_ W <br />(714) 962-2694 <br />COMPANY- <br />A FIRST FINANCIAL INSURANCE COMPANY <br />INSURED HOOPS UNLIMITED <br />COMPANY <br />P.O. BOX 80541 <br />B <br />RANCHO SANTA MARGARITA, CA 92688 <br />COMPANY <br />C <br />COMPANY <br />D <br />COVERAGES <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAIAD ABOVE FOR THE POLICY PERIOD <br />WDICATED, NOTWTTHSTANDWG ANY REQUIREMENT, TERMS OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED B Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LMTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIVI.S. <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICYEXPIRATIONRATION <br />LIMITS <br />`co <br />DATE IMMMIDDm1 <br />DATE <br />GENERALLIABILITY <br />OENE�RALAGGREGATE___l <br />S 1.000,000 <br />A <br />X <br />COMMERCIAL GENERAL UASILriYi151F001311 <br />01-29-09 <br />01-29-10 <br />PRODUCTS -COMPIOPAW,S- <br />INCLUDED <br />PERSONAL 6_ ADV INJURY - <br />— <br />$ 1,0_00,000 • <br />- <br />-- CLAIMSMADE ocCUR <br />OWNEITS B CONTRACTOR'S PROTf <br />EACH OCCURRENCE <br />S 1.000.000 <br />FIRE DAMAGE (Any—fim) <br />— _ <br />$ 100.000_ <br />----`- <br />MED EXP (Any one person! <br />S 5.000 <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />I S <br />ANY AUTO <br />tl <br />ALL OW NED AUTOS <br />BODILY94JURY <br />S <br />SCHEDULED AUTOS <br />(Per person) <br />_ <br />._.. __.._•--_-- _..� <br />- <br />HIRED AUTOS <br />BODILY INJURY <br />s <br />NON -OWNED AUTOS <br />(Per xccideaQ <br />-- <br />PROPERTY DAAGE <br />M <br />I <br />$ <br />GARAGEUAB4fTY <br />AUTO ONI.Y-EA ACCIDENT <br />S <br />ANYAUTO <br />OTHERTHANAUTOONLY: j <br />5 <br />EACH ACODENT <br />AGGREGATE <br />S <br />EXCESS LIABILITY ! <br />EACH OCCURRENCE <br />S <br />UMBRELLA FORM <br />i I <br />AGGREGATE , <br />S <br />Oi14ERTHAN UMBRELLA FORM <br />' <br />S <br />WORKER'S COMPENSATION AND <br />j <br />STATUTO!LIMITS <br />_ <br />EMPLOYERS' LIABILITY <br />EACH ACCIDENT <br />S <br />THE PROPRIETOR/RINCL i <br />DISEASE - POLICY LIMBS <br />- - <br />PARTNERSIEXECUTNE <br />OFFICERS ARE: EXCL <br />DISEASE - EACH EMPLOYEE <br />S <br />i <br />I <br />DESI C -511 Wgwl EHlCLIFSISPECtAEfflW-_ <br />CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED AS RESPECTS ALL OPERATIONS PERFORMED BY OR ON BEHALF OF <br />THE NAMED INSURED PER ENDORSEMENT ATTACHED. <br />'TEN (10) <br />DAYS FOR NON-PAYMENT <br />CERTIFICATE HOLDER <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES Be CANCELLED BEFORE THE <br />CITY OF SANTA ANA <br />EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br />20 CIVIC CENTER PLAZA <br />'30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. <br />SANTA ANA, CA 92701 <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. <br />APPROVED <br />AUTHORIZED REPRESENTATIVE <br />AS TO <br />FO ULVIN WATERSDe <br />I <br />ACORD 25S 3193) <br /><,;l © ACORD CORPORATION 1993 <br />Laura .Fitt Shee@y <br />Assistant City Attorney <br />