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02/05/2010 15:11 <br />AJG <br />~~~ ~ <br />7147541°20 MATER DEI HIGH SCHL <br />PAGE 02104 <br />2/5/2010 2 ; 27:08 PM PAC3E 2/Of14 Fax SePVeP <br />"'~ " C:EKTEFICATE QF LIA BILITY INSURANCE °ATE`~`'''°°'Y`'r" <br />vROOUCCR 07464A3 <br />i-915-596-s3o0 <br />Art)du <br />~ <br />1 04!02/10 <br />THIS CERTIFICATE IS ISSUED A5 A MATTER OF INFORMATIO <br /> <br />r <br />' 6e1 <br />agher ° Co. <br />meureaoe Hroker• o! Calilasaiw, xaa., Liaeaee 90796493 <br />o <br />9 N <br />ONLY AND CONFf;RS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND <br /> <br />ne > <br />sskeE Plnca, Eipear lbvlsr <br />euii;e 400 , EXTEND OR <br />ALTER THE COVERAGE AFFOfZpED BY THE POIICIE5 BELOW, <br />Ssa YraaoiReo, CA 99105 <br /> <br />INSURED INSURERS AFFORDING COVERAGE NAIC # <br />Romaa CsEholio laiabop o! oraape INSI,IRER A: oRDIRARY MO',I' .RRO OORP _ __ 16171 <br />7811 Beat Pills Real Drive TINSURERB: <br /> INSURER G: <br />Osage, C71 92863 INSURER D' <br /> <br />COVERAGES INAUgER E: <br />TFiE rOLICIF=S OF INSURnncE uSTt=u i3ELOW HAVE BEErv iSSUeD TO IME INSURED NnME:D ABOVt FOR THE POLICY PERIOD IrvuICATED, NOT1NITfISrnNOwC~ <br />ANY REOUIREMENr, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENr WITH RESPECT TO WHICH TH19 CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBUEC7 'f0 ALL THE TERMS, EXCLIISION3 AND CONDITIONS OF SUCH <br />POLICIES. AC~ORL--GATE LIMITS SHOWN MAY'HAVE BEEN REDUCED BY PAID CLAIMS. <br />A GENERAL LIABILITY <br />S COMMERCIALOENERALUABILITY <br />- _ OLAIMS MMF ~ OCCUR <br />LIMIT APPLIES PER: <br />aUTOM031LE LIABILITY <br />ANV AUTO <br />ALI, AWNED AUTOS <br />SCWF_DULEDAUTDS <br />HIRFO lu1Tf>.C <br />NON-0WNED AUTOS <br />AGE LIABILITY <br />ANA AUTO <br />CbAL6040A <br />APPROV~;17 <br />'96 7UM9REI_I,A I,IApII.ITV <br />OCCUR ~ CLAIMS MADE <br />DEOUCT~LE <br />AND EMPLOYERS' LIABILItt <br />ANY PROPRIETOR7PARTNERlEX000TA/E <br />OrFIOERfMEMDER EXCLUDED? <br />(ManEatorV In NWtl <br />II d~.CfIfO UINJOr <br />6~ECIAL PRgtnSIONb Im~nw <br />OTMIER <br />07/01/09 D7/D1/10 <br />EXP <br />SO,ODO <br />D <br />ADV INJURY S 1, ODO, 000 <br />gREOATE E 4 , 000 , 000 <br />CDMPrpP AG6 S 2 , 000 , 000 <br />COMBINED SINGLE LIMIT <br /> <br />(En nr~ltlenr S <br />DODILY INJURY <br />(Perpenenn ~ <br />BODILY INJURY <br />(Perneeleenl- $ <br />PROPERTY DAMAGE <br /> <br />(PoraodEenl_ S <br />AUTO ONLY • EA ACCIDENT f <br />OTHER THAN En ncc .ry <br />AUTD ONLY; . _ _ <br /> <br />S <br />E,l„EACH ACCIDENT s <br />E.L. DISEASE • EA EMPLOYEE ¢ <br />E.LDI3EASE-POLICY LIMIT S <br />DESCRIPTION OF OPERATIONS /LOCATIONS ! VEWICLES / EXCLUSION5ADDED BV ENDORSEAIENT! SPECIAL PROVISIONS <br />IlE, >lraeer Dei Higb SelSeel, 1404 KeeE Sdiager Aveaue, SaaEe Aaa, CA 92707. As ze <br />of MesC Bosshard Ave. and HriB~ol SE. L'or SveaC Scalp Parking afu teltruary 10. SOlOatCiCYeo=LS6uIC AAg9~~oiCl1 e~>cioaz,pnez <br />9't~ka. emplayeea, represeaEativee sad wluaCeasa are listed sa Addit:ioaal Enaux'ed only nLere vvatreot z-egui,r4le per <br />sttached eadoreenleat form CG2026 1185. PRZDrARYa 2t ie ,understood sad agreed thaE this iaauraaae is primazy and nay oCh~ <br />Laeuranea maiataiope by tha >-dditiOm41 Laaurad phnll bo axoppp °T';Y ~+~ not oeaErihuElag rich Ebia iaauraaao_ <br />City of SanEe Ann, 1Ee o!lleors, ageaEa, ®mpioyapa, <br />rePreeeateEivee aaA velunt:eera <br />P o Hme 1968 <br />40 Civ10 Qe>aCea Dr. <br />3saea Aas, G 92704 <br />(ZOD9101) <br />l,I~s~o7s <br />- - r.vf. -i-eci Dap NoCioe !ar Nos-PaymenE o! Premium <br />SHOULD ANY OF THE ADOVE DESCRID ED PO'_ICI ES BE CANCELLE J DEFORE T11E EXPIRATION <br />DATE TWEREOF, THE ~ WNG INSURER WILL ENDFI~VOR TO MAII. 30 ~ IIAYb WRII'fEN <br />NOTICE i0 THE CERTIFIOATE HOLDER NAMED TO TWE LEFT, BUT FAILURE TC DO SO SWALI_ <br />IMPOSE NO OBLKL4TION 4R LIAB11.11Y OF ANY KIND UPON THE INSURER, 1T3 AGENTS OR <br />ALfiNOR12ED REPRESENTATIVE -~ <br />The AGORD name and loco are registered marks o~~CORD~D CORPOI <br />Laura ~fti;1 ~t'• _,~~'~ <br />;E~,SSIStBIIt ClIV A i,3rrle- <br />TION. All rights <br />