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ACORD,CERTIFICATE <br />—7 <br />OF LIABILITY INSURANCE -7 <br />DATE(MM/DD/YYYY) <br />04/08/2010 <br />HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />HIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the <br />terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />K&K Insurance Group, Inc. <br />1712 Magnavox Way <br />Fort Wayne IN 46804 <br />CONTACT NAME: Mass Merchandising Underwriting <br />PHONE (A/C, No. Ext): 1-800-328-2317 FAX (A/C, No): 1-260-459-5502 <br />E-MAIL ADDRESS: info@eventinsurance-kk.com <br />PRODUCER CUSTOMER ID#: 10151261 <br />INSURED <br />Baby Signs by Yvonne Chow Greenwald <br />7432 E Skyline Drive <br />Orange, CA 92867 <br />A Member of the Sports, Leisure & Entertainment RPG <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURER A: Nationwide Mutual Insurance Company 23787 <br />INSURER B: <br />INSURER C: <br />INSURER D: <br />�IUvCrlmurzo t_EFiI iFiCAIt NUMIit M: 10172741 RFvISIr1N NI 111ARFR- <br />HIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE <br />ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF <br />SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />MM/DD/YY) <br />POLICY EXP <br />MM/DD/YY <br />LIMBS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE X❑ OCCUR <br />66RPG0000004813500 <br />� <br />04/06/10 <br />12:01 AM <br />04/06/11 <br />12:01 AM <br />EACH OCCURRENCE $1,00.0,000 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence $300,000 <br />MED EXP (Any one person) <br />PERSONAL & ADV INJURY $1,000,000 <br />GENERAL AGGREGATE $3,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY PROJECT =LOC <br />PRODUCTS-COMP/OP AGG $1,000,000 <br />PROFESSIONAL LIABILITY $1,000,000 <br />LEGAL LIAR TO PARTICIPANTS $1,000,000 <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea Accident <br />ANY AUTO <br />City <br />BODILY INJURY (Per person) <br />ALL OWNED AUTOS <br />Ol Santa Ana C <br />�, Atto <br />BODILY INJURY (Per accident) <br />SCHEDULED AUTOS <br />zmey <br />PROPERTY DAMAGE <br />HIRED AUTOS <br />Item has b <br />Per accident <br />NON -OWNED AUTOS - <br />1� <br />Dev• <br />X <br />7I <br />Not provided while in Hawaii <br />sewed: <br />a <br />UMBRELLA LIAB OCCUR <br />pgroved: <br />EACH OCCURRENCE <br />EXCESS LIAB CLAIMS -MADE <br />Date: <br />- <br />AGGREGATE <br />DEDUCTIBLE <br />RETENTION <br />WORKERS COMPENSATIONN <br />AND EMPLOYERS' LIABLITY Y / N <br />ANY PROPRIETOR/PARTNER/ <br />/ A <br />TWC STATU- <br />ORY LIMITS OTHER <br />E.L. EACH ACCIDENT <br />EXECUTIVE OFFICER/MEMBER <br />EXCLUDED? <br />(Mandatory in NH) <br />E.L. DISEASE — EA EMPLOYEE <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE — POLICY LIMIT <br />MEDICAL PAYMENTS FOR <br />PARTICIPANTS <br />PRIMARY MEDICAL <br />EXCESS MEDICAL <br />DESCRIPTION OF OPERATIONS / LOCATIONS !VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />RE: Sign language instructor CL# 9 —REPLACES CERTIFICATE: 10121853— <br />0121853—The City of Santa Ana, its officers, agents, employees and volunteers are added as Additional Insured, but only with respect to the liability arising out of the <br />The <br />operations of the Insured named above. <br />City of Santa Ana <br />Attn: Donna Schultze <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />888 W Santa Ana Blvd, 2nd Floor <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />PO Box 1988 <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana, CA 92702 <br />Owner/Manager/Lessor of Premises <br />Coverage is only extended to U.S. events and activities. <br />" NOTICE TO TEXAS INSUREDS: The Insurer for the purchasing group may not be subject to all the insurance laws and regulations of the State of Texas. <br />ACORD 25 (2009/09) ©1988-2009 ACORD CORPORATION. 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