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A0?o CERTIFICATE OF LIABILITY INSURANCE <br />DA 08127120014 Yi <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder In Ileu of such endoreement(e). <br />PRODUCER <br />CHOICE FAMILY INSURANCE AGENCY.M%ESO. <br />1613 E. CHAPMAN AVE, <br />FULLERTON,CA92831 <br />CONTACT <br />NAME: <br />714.525.4555 al C. No7: 714-525-8848 <br />MAIL <br />INSURER(S) AFFORDING COVERAGE <br />--- <br />NIUCR <br />INSURERA: AMERICAN CASUALTY COMPANY <br />20427 <br />INSURED <br />BODY AND BRAIN <br />5753 E, SANTA ANA CANYON RD#E <br />ANAHEIM, CA 92807 <br />INSURERS: NATIONAL FIRE INS <br />20478___ <br />INSURERC: <br />EACH OCCURRENCE S 2,000,000 <br />INSURER 01 <br />MEO EXP A ons aeon $ 10,000 <br />INSURER B: <br />INSURER F: <br />GEH'L AGGREGATE <br />POLICYFj <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.INSR <br />LTR <br />TYPE OF INSURANCE <br />D <br />BLSU <br />POLICY NUMBER <br />ammo EFF <br />MMNO EXP <br />__ <br />LIMITS <br />A <br />GENERAL LIABILITY <br />CDMMERCNL GENERAL LIABILITY <br />CLAIMS -MADE ® OCCUR <br />B 4031553307 <br />04101/2014 <br />O <br />04/0112015 <br />EACH OCCURRENCE S 2,000,000 <br />PR IS�ESEawcu lrce $ 300,000 <br />MEO EXP A ons aeon $ 10,000 <br />PERSONAL &ADV INJURY S_ 2,000,000 <br />__ <br />GENERAL AGGREGATE S 4,000,000 <br />GEH'L AGGREGATE <br />POLICYFj <br />UNIT APPLIES PER: <br />PRP LOC <br />PRODUCTS-COMPIOP AGO S 4,000,000 <br />$ <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />AUTOOS ED SCHEDULED <br />HIREDAUTOS NON -OWNED <br />AUTOS <br />l -,ROY <br />- - <br />TO <br />JOSei$T <br />'tYak <br />� <br />ley <br />Ea aWdM IN E MI <br />BODILY INJURY (Per person) $ <br />BODILY INJURY (Por 00ddenl) $ <br />PROPERTYDAMAGE $ <br />IPeraWdeml__ <br />-- <br />S <br />UMSRELLALIAB <br />EXCESSUAB <br />OCCUR <br />CLAIMS -MADE <br />®9S�St'dTL <br />A <br />EACH CCCURRBvCE $ <br />AGGREGATE <br />PED <br />RETEMIONS <br />iE <br />B <br />WOMEN COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANYP YIN <br />OFFICE RALEMBERE%CLNERIE <br />(Mandatary lnNN) <br />If s, desalbe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />5055940969 <br />0113112014 <br />01131/2016 <br />I NCSTATU- 9TH• <br />E.L. EACH ACCIDENT $ 1,000,000 <br />-- <br />E.L. DISEASE• EA EMPLOYE S 1,000,000 <br />E.1 -DISEASE -POLICY LIMIT $ 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ARach ACORG 101, AddlUpnal Facades Schodulo, If mom apace is m4ulmd) <br />CERTIFICATE HOLDER IS, ITS OFFICERS, AGENTS, AND EMPLOYEES ARE NAMED AS ADDITIONAL INSURED IN REGARDS TO GENERAL LIABILITY <br />PER ATTACHED CG 201511/86 <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2010/05) ®1988-2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />CITY OF SANTA ANA <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ATTN: f'fzc`J 'IA <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 CIVIC CENTER PLAZA <br />AUTHORIZED RSP nVB <br />SANTA ANA, GA 92701 <br />ACORD 25 (2010/05) ®1988-2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />