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AxlsaoooJOe/7o> CERTIFICATE OF INSURANCE o4/zs/zD17 <br />PRODUCER THIS CERTIFICATE la IaaUEO AS A I.fATTEN OF INFORMATION OrRY .:IJO COIIFE RS NO <br />American S eciall Insurance Ba RI51( SQNICeS, InG <br />p y glGHia UPON THE CERTIFIGTE HOLDER. THIS CERTIFICATE 00Ea NOT AFFIRI.I:.TIVELY <br />Oq NCGATNELY A1.lE1aO, EXTEND. OR ALTER THE COVERAGE AFFORDED 0Y THE POLKIES <br />742 North Mafn $Ireel BELOW. THIS CERTIFIUT@OF INSURNJCE GOES ruOS COnSTITUTEACONTgACT <br /> <br />Roanoke Indiana 46763 BETWEEN THE ISSUING INSURERIS) AUTHORIZED REPgE SEIJiATIVE OR CROOUGEq AIJD <br />rRE C@grwlcnre noLOeR. <br />INSURED INSURERS AFFORDING COVERAGE <br />The National Archery Assoc(alion of the U S INS. A: AXIS IlTSUrance Company <br />Ono Olympic Plaza <br />C <br />i <br />l <br />d <br />S <br />CO INS. B: <br />o <br />ora <br />o <br />pr <br />ngs. <br />80909 INS. C: <br />SANTA FE TRAIL ARCFIE RS Iv WOK-QO ? - O ?? -O <br />17339 MULHALL STREET <br />EL MONTE. GA 91732 <br /> CERT NUMBER: 7000953549 <br />l: V V CKHl3CJ <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTEO aELOW HAVE BEEN ISSUED TO THE INSURED NAI.IED AEOVE FOR THE POLICY PERIOD INDICATED. NOT WITNSTAIJDIIJG AIJY <br />REOUIREI.?tENT, TERIA OR COIJDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPEGi TO WHICH THIS CERTIFICATE MAY 6E ISSUED OR h1AY PERTAIN, THE Il•ISURAIJCE AFFORDED BY <br />THE POLICIES DESCRIBED HEREIN IS SVa)EGT TO ALL THE TER615. EXCLUSIONS AND COIJDITIOIJS OF SUCH POLICIES LIhi1T5 SHOWI.1 MAY HAVE BEEN REDUCED 9Y PAID CLAIMS <br />INS <br />LTR POLICY <br />TYPE <br />POLICY NUMBER POLICY <br />EFFECTIVE POLICY <br />EXPIRATION <br />LIMITS <br /> General A re ate S,000,ODO <br /> GL AXGL03700381-11 01/15/2011 01/15/2072 Products-Com Ieled O erations A re ale 2,000,ODO <br />/->\ Personal and Advertisin In'u 7.000,000 <br /> 12:07 a m 12:01 a m Each Occurrence 7.000.000 <br /> P ml R nl 1 You n n Premi es 300 000 <br /> Medical Ex ense Lirrlil An Ono Parson Excluded <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />DESCRIPT]ON OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />The c¢rlificaleholder shall be an additional inaur@d. but only wllh respect tD the operations of lhB Named Insured. and subject to the provlsfons end IimllaUOns of Form CG 202G - <br />Addilional Insured -Designated Person or Organizallon. but only with respect l0 PARKS ANO RECREATION PROGRAM AT SANTIAGO PARI<ARCHERY RANGE from April 22. 2011 <br />Ihrau9h January 19.2012 <br />?tzi'RC?7b3?1J A5 l U F"/CJtZM <br />? / ? __ <br />Laura ScLt? it?cdy--?E? <br />Cit Attor-ncTr <br />v r...1\Ill IvJ^ll ? •IV VVr-1\ Vt11YVLLLMI IVIY <br />- Yv vl..wrv I vcr\.? SHOVLD ANY OF THE ABOVE DESCRIBED POUGES <br />PARKS, RECRATION AND COMMUNITY SERVICES AGENCY aE CAIJCELLED 6EFORE THE EXPIRATION DATE <br />20 CIVIC CENTER DRIVE TIiEREOF. NOTICE WILL 6E DELIVEAEO IN <br />SANTA ANA. CA 92703 ACCORDANCE WITH THE POLICY PROVISIONS <br />A:I?1 <br />nsurance <br />as