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05/16/2012 11:28 9496462566 SHAHIN CHEAR� PAGE 03/03__ <br />oATE tl+<LamomYYl <br />ACOR CERTIFICATE OF LIABILITY INSURANCE 0511412012 <br />T /E 19 NOT <br />ASA MATTER OP INFORMATION LY A ONLY,C EN O EALTERS No RTH6 COUPON <br />VERAGE AFFORDED a THE POLICIES <br />ES NOT TE OFtINSUR Y OR t�t$ATIOT C AMF�, <br />CERTIFICATE OF INSURANCE ROES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSWNO INSUREFt(SI, AUTHORIZED <br />R �/� OR PRODUCER, AND THE CERTIFICATE HOLDER, <br />EMAPMTAff` <br />IfthDrtNlcata holder Isan AAI3ITIONAt.11"ISUftEO, the poliey(lemust baondorsed. H SUBRf'GAON IS WANED, 9tJtlJect to the <br />and condltit?ne of the Poq�'� cot"In policies may mclulm an endorsement.Astater,netlt (yn thla cerdf(tate does notCorlfar rights to the <br />lica" hDlder In lieu of et:ClT endarsetnenf�aj, SHAHIN CHIEAiR ANDIOR MMY RICHARD$ <br />PRoalc�x SHAHIN CHEAR, AGENT LIC. #OE0774fi p" gbg.553-1x15 Art Ro 949-satY256s <br />STATE FARM INSURANCE <br />1618 NEWPORT BLVD PNl4 cr <br />INSURE A PORMW CWERAOf3 AIC r <br />-�- COSTA MESA, CA 92627-3716 state Farm General Insurance C"PanY 26161 <br />tWsurtER A <br />;Sump <br />JONES, MONIK t"suRT'TEa <br />1111 S ATLANTIC BLVD AFT B ' c <br />ALHAMBRA. CA 91803 2406 IN uRPjl D: <br />asURI'rt 9: <br />f SORER F <br />COVERAi3E3 <br />CERTIFICATE NUMBER: ERSItl810N N�.IMBFR: <br />THIS iS TO CERTIFY THAT iH% POLICIES of INSURANCE USTEI) BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. IERMF TtWI GING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPEOT TO VWICH THIS <br />INDICATED. <br />MAY (3E ISSUED OR MAY PERTAIN, T, t4SUftANCE AFFQRnED BY THE POLICIES DESCRIBED HEREIN IS suBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH PQLIVIRS. LIMITS 5HOINN MAY HAVE HIEN REDUC ABY PAIQ CLAIMS. LIMITS <br />IN TYPQOPINSURANCSsw AUMltER 1,000,000 <br />EACH OCCURREIJCE S <br />A C(EPALIJA UTY <br />MI5 00 $ <br />i� coMMERCM 0ENER& I MIMY S 000 <br />CIAIM34MDE OCCUR 9'�-GQ•E77�$� 85MV201R 0611412013 MEO EXP on" ana�T S <br />pt tt60HAL S ADV I WURY s 4.aao ODo <br />SUSMSS IN RESIOEWE ccNERAIaGL tEcutT£ $ 2,0/10,000 <br />SCHOOLS -MUSIC x,000 oao <br />ARODUCTS-00.'MOP AW $ <br />OWt. AGOR£DATE LIMITAPPLI&D PM- <br />I, <br />PR: # <br />POUCY P LOC <br />AUtOMO>fitLE LIARItjTY <br />reOMIANW INaLI= LIMIT = <br />ANY AUTO BODILY INJURY (Per per) S <br />A0,OWRECAu103BODILY(NJURY(ftf110 0110 3 <br />PROPeRTY DAMAGE <br />SCHE7ULED ewros s <br />NtREDAYJTOS <br />NON DOMED AUTOS / s <br />OMBRiLLA LfAe OCCUR - ` EACH OCCURRENCE S <br />EXC£SB JAV CLAIM9-MADE AGC#tE0A1E 4 <br />S. <br />R N Y S ATU- Orn- <br />MYCPCCP�B PENSATON <br />AND9MPLOY> WLIARILITY UNIA E,L, EACH ACCIDENT S <br />ANY PA09111lem"ARINIM OEf(9CUT(VE. <br />OFFIcERWABEp EJ(CLWFC9 LiL MPS1; - EA EMPLOYE S <br />A yes p&Kic141d <br />E.. DFq_5FS .RUGA iON S <br />q t' AP ES <br />20OAryaw"mm NOTICE Op CANCELLATION FOR NON <br />' PaTINENT <br />DESCfefpflONOPOPERA'ltOMatLOCAT10N8tUENICLCs(AkfehaCa�Olof,AtltlltlaadR�rllay�MkOlaoroapwe4►►+q�lrod} <br />AC?QITIONAL INSURE]: CITY OF SANTA ANA PARKS, RECREATION & COMMUNITY SERVICES AGENCY <br />CERTIFICATE HOLDER CANCEL I,ATION <br />CITY G> SANTA ANA PARKS, RIeCR 4TION 8 COMMUNITY SHOULD ANY or THE ABOVE DESCMH£O POUCfE% 6E CANCELLED OEFORe THF <br />EAPI ' DATE ERM <br />P, NOTICE AE O&AMRED IN ACOOIIOANCE WITH THE <br />SERVICES AGENCY Po P 0VIs1 <br />1825 w Civic CENTER OR <br />SANTA ANA, CA 92703-2821 AOWAMO RGpRESENTATIVE <br />SHAHIN CHEAR, AGENT <br />01988- 2409 ACORD CORPORATION. All tights reserved. <br />ACORD 25 (2008149) The ACORD v;kme and logo are registered marks of ACORD 1001488 132849.4 02^41.2010 <br />