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' JAN-9-2009 12:38P FROr1: <br />70:17148352289 P.2~3 <br />CERTIFICATE OF LIABILITY INSURANCE I °;'~g.;"~"/0.;'~Y'~"'al <br />'~ ~77)41~21Q_1079 _.. ___ __ <br />Lake Insurance Agency ~~ <br />13x91 Newport Ave., suite gas <br />Lic #10747473 <br />Tustin, CA 92780 <br />38- <br />oNL <br />THE <br />•.•....yC wuniy c.n~Igren's <br />Art Center Inc <br />2215 N Broadway <br />Santa Ana, Ca 92706 <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES 6E OR . <br />IN3URER3 AFFORDING COVERAGE NAIC # - <br />ut c a~suRERA: Philadelphia Insurance Co. <br />INSURER B; -_. <br />IN8URER C: ._. <br />INSURER D: -- <br />__ INSURER E; -._. <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BE <br />EN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN;; <br />MAY PERTAIN, THE INSURMigNCE AFFORDED BY T <br />E <br />~ <br />H <br />POLIC ES DESCRIBED HEREIN <br />S SUBJEC <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN,REDUCED BY PAID CIAIMS T TO ALL THE~ERMS. EXCLUSIONS AND COND TIONS OF SUCH <br /> <br />NIR . <br /> <br />TYPE OF INBURANCB POLICY NUMBER POLICY HFFT,CTA?s <br /> <br />POLICY iXPIRATK)N <br /> aeNERAL LU16rurY PHPK3698 f 3 12/21 f 2008 LIMIT6 <br /> <br />X Gf1MMFRf:lA1 AFNFRAI I IARII.ITY ' <br />12 j21/2009 lALH ~CURR!!NE! _ <br />~., 888, 881 <br /> C1AIM3 MADE Q OCCUR DAMAGE TO RENTED S 1Q4 ~ Q¢` <br />A MEO EXP (Any one person) S 5 , 0 0 ~ <br /> PERSONAL 8 ADV INJURY i 1 000 ~ 00~ <br />GEN'L AppREGgTE UM.IT APPUE8 PER: GENERAL AGGREGATE 6 2 OOQ , OOf, <br />POLICY ~ec°T Loc PRODUCTS • COMProP AGG s 2 000, oUa <br />AuroMOelLe LuBILIrY PHPK369873 12/21/2008 <br />A 12/21/2009 <br />NY AUTO COMBINED SINGLE LIMIT 3 <br />All OWNED AUTOS <br />(~ e«laeno <br />l , 000 OLIO <br />A SCHEDULED AUTOS BODILY INJURY S <br />X HIRED AUTOg (Per person} <br />X NON-OWNED AUTOS BODILY INJURY <br /> (Pereccltlanr~ 3 <br /> <br /> <br />OARAGH LUIBIUTY PROPERTY DAMAGE b <br />(Per eeddenl) <br />ANY AUTO ~ ~ AUTO ONLY - EA ACCIDENT S <br />~ ~ . <br /> ~.~ <br />_ <br />~~- OTHER TNAN EA ACC S <br /> <br /> <br />EXCE68rUMBRELLA LUU9ILITY _ <br />.- AUTO ONLY: AGG S <br />Ll <br />C <br />OCCUR a CLAIMS MADE J <br />° - S 1~~ EACH OCCURRENCE : <br />- <br />y <br />G <br /> ' <br />AGGREGATE g <br />~ 4ti <br />` <br />DEDUCTIBLE S <br />~ ~ <br />RETENTION >< S <br />WORKiRB COMPENiAT10N ANp S <br />EMPLOYERS' LIABILITY WC 8TATU- OTH• -- <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />O <br />F <br />FICERMIEMBER EXCLUOED9 E,L EACH ACCIDENT <br />$ <br />~~ <br />! <br />BPEGIIAdL PR VISIONS below E.L. DISEASE - EA EMPLOYE S _ <br /> <br />4 ro~`essional Liability E.L. DISEASE • POLICY LIMIT S i <br />PHPK369873 12/21/2008 12/21/2009 Incident Limit: 51,000,000. <br /> Aggregate Limit: S2.000,000. <br />ESCRlP IpN OF pP RA ON8 ! LpCATgyyB J VHyICLEB EXCLU8X1N8 ADDED BY ENDO BEMENT / SPECIAL Pg VISIONg <br />artifiicate older is Agditlona'~ Insu <br />d <br />~ <br />re <br />as per <br />orm CG2005 (11/85) <br />ruse & Molestation is included with General Liability 525,000 Each Incident and 350,000 Aggregate <br />its Certificate Superced <br />P <br />es <br />reviously Yssued Certificates -Corrected Policy Number <br />:xcept ZO Days Notice of Cancellation for Non-Payment of Premium <br /> sFiOULD ANY OF THE ABOVE DEBCRIBHD POLICIES BE CANCELLfiD BEFORE THE i <br />Santa Ana Poi ice Athletics & Acti vities EXPIRATION DATE THEREOF, THE188U1N01N9URERWILLENDEAVORTOMAIL f <br />League <br />Attn ; Tom Sera Fi n x'30 DAYS WRITTEN NOTIGE TO THE CERTIFICATE HOLDER NAMED 70 7HB LEFT, <br /> <br />2627 west McFadden Street BUT FAILURE 70 M SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br /> <br />Santa Ana, CA 92704 OF ANY KIND UP T EINSUR 178 GEN75ORREP S8N7ATIVES. <br />- <br />AUTNORIZED REPR ENT <br />- <br /> ~/ <br />y`; -„ `~ M <br />,CORD 2b (2001f08) J <br /> ©ACORD CORPORATION 1988 <br />~~ y. ~~ <br />