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A C a DATE (M D DJY YY) <br />TM- CERTIFICATE OF LIABILITY INSURANCE 1210912009 <br />PRODUCER Phone' (800)395-807 Fax (886)422-8579 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 />SLANA BEACH CA 92075 ALTER -THE COVERAGE AEFORDED BY THE POLICIES UELQW, <br />INSURERS AFFORDING COVERAGE MAIC ## <br />Agency Lic#: 0377845 <br />INSURED INSURER A: Philadelphia Indemnity Insurance Company j <br />CHC V. LE INSURER B: —{— <br />FABIAN IRVINE CA 92820-2576 INSURER C: — <br />INSURER D - <br />INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT1 ITH TANDIN <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 CLAIMS. <br />L—INSWADUR TYPE OF INSURANCE POLICY NUMBER POLICYEFFE THE POLICYrzXPIRATIONi INR DATE Mln+rO DATE MMlDD <br />LIMrT <br />GENERAL LIABILITY PHPK 04907 12117109 12/17/10 <br />EACH OCCURRENCE � <br />1,000,000 <br />COMMERCIAL GENERAL LIABILITY <br />—_ <br />DAIVAE TO RENTED <br />PREMISE S <br />100,000 <br />j <br />CLAIMS MADE OCCUR J <br />(Ea occurerom) <br />HIED- <br />-- ,-- <br />EXP (Any one person) S <br />r 500 <br />A _ <br />PERSONAL & ADV INJURY <br />1,000,000 <br />GENERAL AGGREGATO4 <br />,0�� = <br />GEN'L AGGREGATE LIMIT APPLIES PERS <br />P RO- � ORME <br />- -] �� <br />" -- <br />PRODUCTS-COMPIOP S <br />, 000 <br />�' POLICY .ECT LOC <br />� �.— <br />i <br />AUTOMOBILE LIABILITY <br />NE Sf�VGLE �.IMIT <br />ANY AUTOR <br />�] <br />(Ea accident) S <br />H W7 <br />ALL OWNED AUTOS <br />!1 -Tr A EY <br />PrO. <br />BODILY INJURY <br />' SCHEDULED AUTOS <br />(Per person) S <br />HIRED AUTOS <br />NON -GINNED AUTOS <br />BODILYINJURYINJLJRY <br />(Per accident) <br />PROPERTY DAMAGE <br />(Per accident) <br />i GARAGE LIABILITY r <br />� <br />AUTO ONLY - EA ACCIDENT S <br />ANY AUTO f <br />F <br />OTHER THAN EA ACO — <br />– -- <br />I <br />AUTO ONLY, <br />EXCESS I UMBRELLA LIABILITY <br />EACH OCCURRENCE <br />OCCUR � CLAIMS MADE <br />AGGREGATE -- - <br />--- y <br />t <br />DEDUCTIBLE— <br />RETENTION S <br />- <br />S <br />WORKERS COMPENSATION AND <br />WC $TATA I OTHER <br />TORY LIMITS <br />EMPLOYERS' LIABILITY <br />ANY PFtOPMETOWPARTNERIFXECUTNE f <br />— <br />E- L. 1=ACH ACCI DENT <br />OFFI ERlMEM13ER EXCLUDED? <br />E.L. DISEASE -EA EMPLOYEE <br />If yes, describe under <br />- - • <br />—� <br />44L PRCWK)NS below <br />E -L_ DISEASE -POLICY LIMIT <br />ER- <br />rDESCRIPTIONF PERATI NSIL C TIDNS111EHICLESIEXCLU I NS ADDED B ENDORSEMENT/ SPECIAL PROVISIONS <br />PPLEMENTAL CERTIFICATE INFORMATION <br />I P ,* ezp c 6,W Cn <br />CERTIFICATE HOLDER ANr.Fl I ATIf)N <br />SHOULD ANY OF THE ABOVE D2SCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS <br />WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO <br />Community Redevelopment gency DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, IT'S <br />of the City of Santa Aria AGENTS OR REPRESENTATIVES - <br />20 C iv iD Center PIalza (M -2) AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92701 <br />s <br />Attention: Jeffrey E. Frick, CEO <br />ACORD 2 (2001/08) Certificate # 94514 ACORD CORPORATION 1988 <br />