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<br />A~ORD CERTIF!CATE aF LlABILlTY INSURANCE ~~li~ocg <br />PR77:1C£P. (55i ~ 2$A-1713 FAX: (561} 254-5875 THIS CERTIFICATE 1S I$$IJEp AS A MATTER OF INFORMATfON <br />James ~ Parker Insurance AssacsaCes ONLY ANf7 CBNFERS NO RIGHTS UPON THE CERTIFICATE <br />)iOLDER_ THIS GEIiTIFICATE f7DES NOT AMENf?, EXTENCI OR <br />L~.cens,= tr0554959 ALTER THE COVERAGE AFFORDED BY THE ROLICiES [iELDW. <br />27200 Tourney Rd #35b <br />Va1~=n~?a CA 91355 INSURERS AFEOI;ptNG COVERAGE NAtC k <br />INS URE.D "~ ~~-.,.. <br />INSIJRERA EV@2-BE4t Nat.iPnal <br />:'Fi1dC)rl Co3r13P_ri5 TnC INSURERS -- <br />3231 Mann St f <br />IN SUH ER, ,, j <br />I.+I S{)HEF [~ <br />$e3Tltc'1 ~I'Sa ~ 927Q7 IN$L:f2cR E <br />T:-1= POiICIES OF tN6VRA,N'CE LISTED 9ELGW tiAb'~ yEEN ISSUEG TO THE tNSUREG NAtJ.EO i..BOVE FQR 7F3E POLICY PERIOD ItdD1pATEG. N~OTUATkSTAN;7ING ANY <br />RcOUIREM~NA 1'ERR3 i]R COYD[TI{]N OF AM1IY GQNTiL;CT OR OTHER Q{7CUfdENT'.HFfH RES?ECT TQ WkICh{ THIS CERTIFICATE f:,AY BE ISSUEG QR !.1kY PEP.TAIN <br />TkE IN$i1RANCE AFFORGEO BY THE f~OLICIE$ DESCRIBED HEREIN IS SUBJECT TO ALL TFtE fc"Rh15 EXCLLiS1GNS AN(] CC+NGITIONS OF Sll^,H }'OLIuIES. <br />~4f~?~.~;~-~!«1fTS SHOVIN MAY kAVE p=KN REQUCEQ [3Y A,~iD CI Alauc <br />f~ r'+PE DF cNBLJRANCE I PD).IGY NUMBER <br />GENERAL LIABILITY <br />CDIdb1E?C:AL GEh'EkAI :.rAHILftY <br />~LA'hrS G1{,.Cr ~ OCCUR <br />vE h"!. AyGR=GATE ! :4:T APF%I.IE:i FE H 1 <br />A.UTDI.IQHILE LIABILITY <br />_.„.„,~ <br />RA'Y' AUTD <br />A' L l:l',4JEG A.,lt',ti <br />SC~IEDULCD i,:IT! iS <br />HIZE C {~'.ITfi9 <br />~ NOr]-C'{NEC;-.JT45 <br />GARAGE LIA9I LITY <br />A!:Y AI1'Ci <br />POLICY <br />tLYI'~tU1'~;D ~A~ TC? ~~C?Ith't <br />LwC:J ~~._[ jh <br />EXCE SiUN9RELLA LIABILITY <br />_~ Or_I,UR ~ C:Lt,W15 MAOc <br />_ 1 RF~F.h'TIC;u s <br />Ii WORKERS COMPENSATION ANp <br />I EMPLOYERS' llA61UTY <br />ANY YRC+''RIETCFL"~A2TNCR,E.}IE f, ~-T IL's <br />CF-FICC R'MEAI5 ER E7[C.LUDED~ <br />If ytlY, 4tl5_r1~8 V,tllif <br />OTHER <br />7fiQ4402205491 I6/1/2p4g ~ 6/1/2010 <br />uM]~ <br />~. <br />a <br />^.JMHIh'kU tilh'C LE LIMN <br />fEa dG[ytla~l; 8 <br />BDDI;.Y INJURY j <br />1 i'9r GLSf a4111 3 <br />BODILY INJURY <br />I acr ecc~Ce"111 a <br />L <br />vkU~ER TY D:,MAGE <br />rPnr Btx]tl5nl', 3 <br />AU i() pNLY - EA ACCIDEN? 9 <br />CJTri~R 7yAk -~ <br />nU700F:LY <br />L EhCHACC-IDF.?17 t 1, 0'{J0, QG4 <br />E {, gI$EA5E - EA EMOLDYEE a 1 , O4D , OOO <br />E.L DISEASE - Wn;.ruv LntIT S 1, 404 , 400 <br />DESCRIPTION OF 4PERATi0N31LOCATIONSPlEk7CLESIEXCLUSIONS ABSSEp 6Y Ei1D8RSEIKEnITt$PECIAL PitOVISIONS <br />Sob= L'ity of Santa Ana `1Q day notice o± agnc~llation I,F policy carstpl.a far nor.-payment oL pr4cniu>L; non-renorttng of <br />payrcil, <br />~(71a~ X47-5a~~ <br />City of Santa Ana <br />Az;tn: Jerry ~7effries <br />20 Civic 4enter Plaza <br />Ross eennex (M-Z1} <br />Santa Ana, CF+ 92701 <br />ACORD 25 (2001!98) <br />IN5425 'c:i:,~~ nsa <br />SHOULD ANY OP THE A~VE t]ESCRI9E0 POLGCIE9 BE CANCELLED BEFORE THE <br />E]fMRATH7N PATE THEREOF, THE ISSUING INSURER WILL EJJDEAYDR YO MAIi <br />* 3Q AAYg WRITTEN NOTICE TD 7HH GERT[F7CATE MOLDER NAl,1ED 1'O THE LEFT, 8UT <br />FAILURE 70 DO SO SHALL 9MPOSE NO OBLJGATIOH OR UABCLITY OF ANY K]Np IFPON THE <br />INSURER. ITS AO£NTS OR REPRESE]~ITATIy$g. <br />AUTHOR:IZEp REPRESENT,I,TIVE <br />:J Puzker ?i7/:,:SEES ~a ~ ;~~' j,` <br />ACORD CORPOf2ATlON 1988 <br />ba~c'clr <br />