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AXIS80001081101 CPRTIFICATGnr INIC11oAAIro -..__.__.. <br />AXIS 8000(08170) CERTIFICATE OF INSURANCE <br />04/26/2011 <br />PRODUCER THIS CERTIFICATE 15 ISSUED AS A LATTER OF INFOMIXTIONOMV AIIO CONIFERS 110 <br />American Specialty Insurance & Risk Services <br />Inc RIGHTS UPON THE CERTIFICATE MOLDER. THIS CERTIFICATE DOES NOT w RRIAATIIELY <br />T <br />, <br />142 North Main Street OR NEW <br />WELY AI.IEND, EXTEND, OR ALTER THE COVERAGE AFFMOED BY THE POLICIES <br />"F LOW. THISCERIFI TEOFHSUM411MOMS14OTCA14STOUTEACONTRACT <br /> <br />Roanoke, Indiana 46783 BETWEENTHEISSUINGINSURER(S) AUTHORREDREPRESENTATWEORPNGDUCIR APD <br />THE CERTIFICATE HOLDER. <br />INSURED <br />The Natio <br />l A <br />h <br />A <br />i <br />t INSURERS AFFORDING COVERAGE <br />na <br />rc <br />ery <br />ssoc <br />a <br />ion of the U S <br />One Ol <br />m <br />ic Plaza INS. A: AXIS Insurance Company <br />y <br />p <br />Colorado Springs <br />CO 60909 INS. B: <br />. <br />03 <br />2008 <br />087 <br />N INS. C: <br />- <br />- <br />- <br />SANTA FE TRAIL ARCHERS <br />11339 MULHALL STREET <br />EL MONTE. CA 91732 <br /> CERT NUMBER: 1000953549 <br />COVERAGES <br /> THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT WITHSTA14DING ANY <br />REQUIREMENT, TERM OR 001401 TION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY <br />THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAedS <br /> INS <br />LTR POLICY <br />TYPE <br />POLICY NUMBER POLICY <br />EFFECTIVE POLICY <br />EXPIRATION <br />LIMITS <br /> General Aggregate 5,000,000 <br /> GL AXGL03100381-11 01115/2011 0111512012 Products-Coro leled Operations Aggregate 2,000,000 <br /> A 12 <br />01 Personal and Advertising InIu 11000,000 <br /> : <br />a m 12:01 am Each Occurrence 1,000,000 <br /> Damage t Premises Rented 1 You An One Preml es 300,000 <br /> Medical Expense Llmll An One Person Excluded <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />- The canificateholder shall be an additional Insured. but only with respect in the operations of the Named Insured, and subject to (lie provisions and limitations of Form CO 2026 - <br />Addilional Insured - Designated Person or Organization. but only with respect to PARKS AND RECREATION PROGRAM AT SANTIAGO PARK ARCHERY RANGE from April 22. 2011 <br />through January 14 2012 <br />AS FO FORM <br />?_.? La'lrb Rr.6[ Spec y <br />?•..?nts.n 1. City Attorney <br />S,FCFC I IrluA <br />PARKS, RECRATION AND COMMUNITY SERVICES AGENCY <br />20 CIVIC CENTER DRIVE <br />SANTA ANA. CA 92703 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES <br />BE CA14CELLED BEFORE THE EXPIRATION DATE <br />THEREOF. NOTICE WILL BE DELIVERED M <br />ACCORDANCE WITH THE POLICY PROVISIONS <br />t0, _ <br />Insurance & Risk <br />as <br />ADBncv In the slate