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:ITNESS AND WELLNEBS—� I n �cn, Inuwl a IOL IMUbO A9 A MATTER OF INFORIMTION <br />40 STEVENS AVENUE. BUNT: 703 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />un, ,.ce .u,...��...� ____ ..__ <br />ACORD TM CERTIFICATE OF LIABILITY INSURANCE =DATE tMMIDDNYYY) <br />vt47o10 <br />' DDDER PIw IM01MS101, Per IMelea<eN THIS CEa <br />STEVENS AVENUE, SURE 703 I ONLY AND CONFERS NO RIGHTS UPON THE CEF <br />ANA BEACH CA 87075 <br />HOLDER, THIS CERTIFICATE DOES NOT AMEND. <br />...'. <br />AFFORDING COVERAGE . I NAIC S <br />A <br />Choc V Le <br />a Fabrlano <br />Irvin CA 97370 <br />E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY <br />PERIOD INDICATED, NOTWITHSTANDING <br />Y REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />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, AGRREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PND CLAIMS. <br />1.59 <br />LTi/ <br />ND13% <br />A <br />TYPBOFaIea ca <br />POLICY NIYa[R. <br />MR 111Dd <br />OATa IYmaxie 1 LWRa <br />GENERAL LIABILITY <br />PHPKE81902 <br />12117/2010 <br />12117/2011 EACH OCCURRENCE 1,000,00 <br />O[ COMMERCIAL GENERAL LIABILITY <br />Ea �e�RENTEO PRIMI9Fs {100,00 <br />:]CLAIMS MADE ❑%t DCCUR <br />ED. EXP (Any one anon) 12,90 <br />A <br />x <br />x PROFESSIONAL LIABILITY <br />ERSONAL A ADV INJURY 1,000,0 <br />ENERAL AGGREGATE 3,000,00 <br />EN'L AGGREGATE LIMIT APPLIES PER: <br />RODUCTS-IOMP/OP AGG. 3,000,00 <br />X OLICYROJFJOC - <br />ICT <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />PINY AUTO <br />Ea accident) <br />AULOWNEDAUTOS <br />ODILY INJURY <br />SCHEDULED AUTOS <br />Per portion) <br />HIRED A11T03 <br />DOILY INJURY <br />ON -OWNED AUTOS <br />Per accident) <br />ROPERTV DAMAGE <br />Per accident) <br />ARAGE LIABILITY <br />kUTO ONLY • EA ACCIDENT <br />AUTO <br />YTHER EA ACC <br />WTO ONLY: AGO <br />LESS I UMBRELLA LIAABILITY <br />FR <br />V) }las M <br />-77t <br />AF <br />HOCCURRENCE <br />CUR ❑CLAIMS MADE <br />AGGREGATE <br />EDUCRBLE <br />aura Stat Sh <br />Cdy ,. <br />ETENTIONS <br />ASISta1At <br />is Ly A <br />tOrney <br />RKERS COMPENSATION AND EMPLOYERS' <br />IABILT' <br />TAT}TORY TIER <br />PRomtTORmw1NFRIDlELv1NE <br />MITs <br />ERMEMSER EXCLtro9o7 <br />meeremsuM SPECMLPAOVSONS pales <br />HER <br />It <br />ESCRIPTION OF OPERATIOnIN TION IC EXCLUBIOf1 ADOEO BV ENO MR CNT/ SPECIAL PROWSIONS <br />IIIOL Undo toad and e9reed that Me fsOaMln9 artily Is added an an additional Inured but only an respects Me operations of Me named Insured eecsM that liability resulting from ted <br />d: lona) Insureds eets nepllpenes. The City oI 31-M Ana, Ib Respective ONlcsra, Employees, <br />Agents, Volunteer, and Repneentstivee. <br />CERTIFICATE HOLDER CANCELLATION <br />Ay of Santa Are, <br />0 QAc Center Plata M.25 <br />Santa Ann , CA, 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 <br />DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT <br />FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON <br />HE INSURER, ITS AGENTS OR REPRESENTATIVES <br />AUTHORIZED REPRESENTATIVE <br />ttention: <br />avmu 40 t2UU1%C) Certificate # 84562 ACORD CORPORATION 1988 <br />