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ACDRD TM. CERTIFICATE AF LIABILITY INSURANCE OATS (MIUDD/YYYY) <br />ornsnoDe <br />PRODUCER Phase: f&") 3S'1"75 F.. (am 4n4$10 1913 09RTIFiCA7E IS ISSUED AS A MATTER OF INFORMATION <br />FITHESSAND WELLNESS ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />380 STEVENS AVENUE, SURE 200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />SOLANA BEACH CA 92075 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW- <br />5 <br />AFFORDING COVERAGE NAIL 0 <br />A: Philadelphia rndamnitylnsuranosCompany I fao if <br />Raymundo Suarez <br />NSURER B: <br />010 S Townsend Suest <br />NSURER C: <br />Santa Ana CA 92703 <br />NSURER D: <br />O 1 EXPIRATION <br />DATE 04= <br />SURER E: <br />THE POLICIES Of INSURANCE LISTED BELOTI HAVE BEEN 13SUEDFQ7HE INSURED NAI ED ABOVE R PERIOD INDICATED. N0TL jIITfi$TAN0jNG <br />Y REOUIREMENT, 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 />045 <br />LTR <br />kwi <br />N9 <br />TYPE Of INSURANCE <br />POIICY NVNBBR <br />POLICY OFF60TIVE <br />DA7E (A UMMY) <br />O 1 EXPIRATION <br />DATE 04= <br />MNns <br />GENERAL LIABILITY <br />PHPK430634 <br />0712812009 <br />05118/2010 <br />EACH OCCURRENCE <br />1,000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />lA1MS MADE OCCUR <br />AMAGETORENTEOPREMISE9 <br />Ea ae"cua] <br />$100,00 <br />ED. EXP (Any one person) <br />$2,80 <br />A <br />X <br />X PROFESSIONALLIARILITY <br />ER30?1ALE,ADVINJURY <br />1,000,000 <br />GENERAL AGGREGATE <br />S 3,000,000 <br />EN'L AGGREGATE LIMIT APPLIES PER: <br />RODUCTS•COMPIOPAGO. <br />S 3,000,000 <br />' <br />X OLICY ROJ• OC <br />CT <br />AUTOMOBILE LIABILITY <br />OMBINED SINGLE LIMIT <br />NYAUYO <br />Ea acdden0 <br />9 <br />lL OWNED AUTOS <br />30DILYINJURY <br />CHEDULEO AUTOS <br />Par person) <br />IRED AUTOS <br />0DILY INJURY <br />ON•OW NED AUTOS <br />Per as4den0 <br />ROPERTY DAMAGE <br />��Z. <br />rrll <br />V <br />Per accident) <br />ARAGE LLABILITY <br />NY AUTO <br />�,�.�R(3i <br />UTO ONLY- CA ACCIDENT <br />THER THAN EA ACC <br />UTO ONLY: AGO <br />EXCESS I UMBRELLA LIABILITY <br />CCUR DLANAS MADE <br />L"M <br />•0_V «mot <br />EACH OCCURRENCE <br />AGGREGATE <br />_ <br />EDUCTteLE <br />ETENTION $ <br />)AB ILITY <br />ROPRIETORIPARTNEMBXECVTIVE ORKERSCOMPENSATIONANDEMPLOYERS' <br />Y PMER&EASER EXCLUOEM <br />YwC l i8 <br />T HR <br />�-L- EACH ACCIDENT <br />s, 4axroe oder SPECIAL PROVOH5 lw <br />DISEASE- <br />.17i MIT <br />HER: <br />DESCRIPTION OF OPERATION ILOCATIONSIVE 1C SIEXCLUSIO SADDED BY NDORSEMENTI SPECIAL PROY1 10 3 <br />It Is understood and agreed that the following amity: City of Santa Ana, Its Officers, Employers, Agents, Volunteers d Representatives are added as an additional Insured but only as <br />respwte The operations of the named Insured except That liability resulting from the additional Insureds solo negligence. <br />vu1u1 ,-rrrc rlV6U CR CGNr:FI i &TIrllll <br />City of Santa Ana <br />20 CHID Cantor Plsre <br />Santa Ana. CA, 92)01 <br />SHOULD ANY OF THE ABOVE DESCRIBED PO ICIES Be CANCELLED BEFORE THE <br />EXPIRATION GATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 <br />DAYS YMITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br />FAILURE TO 00 50 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON <br />THE INSURER, IT'S AGENTS OR REPRESENTATIVES <br />AUTHORIZED REPRESENTATIVE <br />Attention: <br />M"'Jmu z� (xUU IJz) Certificate 4 84562 ACORD CORPORATION 1868 <br />