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Jun 29 12 03:17p GARY WENBERG AGENT STAT <br />408"374 `2258 p.1 <br />�'`°R °� CERTIFICATE OF LIABILITY INSURANCE <br />°osrza�2o` 2" <br />THIS CERTIFICATE !S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE C6RTIF)CATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE PdLIC1ES <br />6�iDW- THIS CERTI FiCATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSVING INSURER(S), AUTHORIZED <br />REPRESENfTATIVE OR PRODUCER, AND TKE CERTIFICATE HOLDER. <br />[NIPORTANT: 11 the certificate holder Is an ADDITFONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, sub]ec[ to the <br />Ee rrrrs aril coridltiorLS of the policy, certain policies may require an endorsement A statement on this eerHNeate does not confer rights to the <br />certificate holder in Iieal of such endorsement(3). <br />PROaucER GARY J WENBERG, AGENT LICENSE #0448533 <br />120 W CAMPBELL AVE STE G <br />PQ BOX 842 <br />CAMPSELL CA 95009 <br />KATHtH016tAN <br />pNONeC fAx <br />' 406 374 -3080 No :408 374 -2258 <br />e -wA,�� <br />s, kath l.hom__ a_ n.iwsbgstafefamn.cam <br />PRODVOER <br />- <br />INSVRERS AFFOROiNGCOVEliAGE <br />NAIOf <br />INSURED <br />CENTER FOR i-iEARiNG HF�.LT1 -i FNC <br />2945 BELL RD #122 <br />AUBURN CA 95603 <br />1HSVRER A -Stale FaRn General lrrsuranW Company <br />26161 <br />,NSURERe•S[a[e Farm Mutual Autom otii[e lnsuranae Company <br />26i7e <br />INSURErt c :5teto FRrm Fire and Casualty Company <br />25143 <br />INSURER D - <br />8 <br />INSURER e - <br />5 5,000 <br />INSURER f - <br />S 2.000,000 <br />f`/IV FRdr'�FQ r_F RTI FIf:ATF NI IMRFR• F1CVr�IL]rr NUMr3tK: <br />THIS fS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAlfED ABOVE FOR THC POLICY PE R10D <br />INDICATED. NOITMTHSTANDING ANY RECyU 1REM ENT, TERM OR CONDITION OF ANY GONTFiACT OR OTHER DOCUMENT VNTH RESPECT TO WFlICH THIS <br />CERTIFICATE AU\Y BE ISSUED OR INAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES OESCRIBEO HEREIN i5 SUBJECT TO ALL THE TERMS, <br />ET(GWSIONS ANO CONDITIONS OF SUCH POLICIES. OMITS SHOWri MAY HAVE BEEN REO UCEO BY PAIppD CLAIMS_ <br />ILTR <br />TYPE OFINSURANCE <br />O L <br />BR <br />POUCYN MBEA <br />� D F <br />PMroD IXP <br />� UHII"S <br />A <br />OENERAL LIABIUTV <br />X COMMERCIAL GENERAL I_IABiLnY <br />GWMSJdAOE � OGCVR <br />Y <br />� <br />97- gZ_Q429 -TG <br />r 12M 8/20'11 <br />72J18I20i2 <br />EACH OCCVRREJ<CE <br />s 2.000,OD0 <br />PA EMIS�.^ rra <br />8 <br />MED E%P ( one arson) <br />5 5,000 <br />PERSONAL S ADV INJURY <br />S 2.000,000 <br />GEN ERAL AGGREGATE <br />5 d,000,0D0 <br />GENL AGGREGATE LIllr17 APPLIES PER -_ <br />PO(SGY ?C PRO- LOC <br />PROOVC79- CONF/OP AGG <br />5 4,000,000 <br />b <br />B AUTONOa1LE <br />I <br />- x <br />- <br />X <br />X <br />- � <br />LIABILITY <br />ANY AUTO <br />ALL OVW. ED AV705 <br />- <br />SCHEDV LEp AVFOS <br />HwEDAUros <br />HON- owlvEO avros <br />1565748- F18 -0SE <br />0476647- F18 -05R <br />1644022 - Fib -0SF <br />0432046- F18 -057 <br />19fi 78'12 -F1 8-OSD <br />0692375 - Fib -0SK <br />12H8i2611 <br />12/1Ef2011 <br />D6Ii8/2012 <br />12/18Yt0i1 <br />12/ta12011 <br />12/18Y1011 <br />t2/18f2012 <br />12/18/2012 <br />72/18/2012 <br />12/18/2012 <br />12!18!2012 <br />12118f20i2 <br />CO.NB4YED SINGLE LIM.rr <br />(Ea ea3Yn] <br />b 2.000,000 <br />Q <br />BODILY ]NJURV (Per person) <br />s <br />I <br />BODILY IN.IVRY (PeraW darO <br />f <br />fRgOP��I CDT Af/31GE '- <br />f <br />t <br />f <br />� <br />f <br />Uw OREtlA UAB <br />EXGEfB L1AB <br />OCCUR <br />CLAVAS�.VIDE <br />EACH OCCURRETIGE <br />f <br />AO.GREGA7E <br />f <br />OEOUCTBLE <br />RETENTKJti S <br />f <br />I <br />b <br />G. <br />1VOPKEfLS COLPEN9A'f10N <br />AHD EMPLOYERS• UABJLnY Y/ N <br />ANY PROPRI ECORRARTNERrE %ECU'r1VE <br />OFF[CERlMEMB.R EXCLUDE04 � <br />lNandalory In NHT <br />NN ye a, dasube v�der <br />N / A <br />X7.6 K•F4UD -D <br />121$1/2011 <br />12/31f2012 <br />LVC TA7U- x OTH- <br />E_L EACR AGCIDElIT <br />f 1,OD O,ODD <br />E.L O15E.4SE- EA EMPLOYE <br />f 1- OOO,OOD <br />E_L DISEASE - POLICY IJMITf <br />1.ODO,ODO <br />O65CRIPTION OF OPERATIONS /Lq CATIONS (AttacA ACORD t01, AddRi Rery�rlts SChad,ie, If more apace FS requlme) <br />Laura Skit heady" <br />,�c�.'atxn7�. Lily �SLLOrriel, <br />CITY OF SANTA ANA, ITS OFFICERS, EtVIPLOYEES, AGENTS AND <br />REPRESENTAT]VE:S <br />2D CMC CENYER PLAZA <br />SANTA ANA CA 92701 <br />THE A90VE DESCRIBED POLdES BE CANCeLLED BEFORE TIE <br />THEREOF, NOTICE WILL BE OELIYERED IN ACCORDANCE Wi'r?t THE <br />ACORD 25 (2009109] The ACgRD name and logo aTa registerf -d mOrk�F A�ORD 7007466 132849.4 02 -ti -2070 <br />