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Ql5/04/2015 13:29 9516953763 AMERICAN CAPITAL, PAGE 02/03
<br />_ DAVE (MMIDDM N)
<br />CERTIFICATE Chi^ L_.IABIL� � Y INSUR,�i7�C'E_,
<br />THIS CERTIFICATE IS ISSUED AS A Ivwri -ER OF INFORNIA70h1 ONLY AND CONFERS NO RIGFITS UPON TPiIK CERTIFICATE HOLDER, 'PHIS
<br />CERTIFCATE DOES NOT AFFIRAAATIVEI_Y OR NEGATIVELY All END, EXTEND Oil ALTER THE COVERAGE AFFORDED SY THE POLICIES
<br />ScLOVV. THIS CERTIFICATE OP INSURANCE DOES NOT DONISTI'i UTE A CONTRACT BE "iVUERM THE ISSUING INSURER(S), AUTHORIZED
<br />__ REPRESENT'ATIVE OR PRODUCER, AMID THE CERRTIFICATE HOLDER. _
<br />5-[P- r•YTARIT: IP tha certifcate Molder i9 en NDD(TIONAL IINSUR'FD, the Hollcy(ies) must L1e endonsed. Iv" SUHRDGA'�IOFd IS W�ANEO, BubJect to
<br />the terms and conditions of Rhe policy, csllain policies may require an endorsement. A matement on U119 certiflcait, does not confer flghts to the
<br />eer licate holder lei Ileu of such erldomeTrlenVie). _____ „_ „.. »—� . —.__._ - - -. •-- '� - -•--
<br />PR00%J"R
<br />Co:Lluctors Inzvranca Agar,,,cy
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<br />2 "1919 JEF'MtSO%NT N,vE STE 206
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<br />MTFIIS 15 TO CEP,TIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />IIVOIDATEO, NOTWITHSTANDING ANY RECUIREN'IF.NT, TERM OfR CONDITION OF AM! CONTRACT OR OTWER DOCUMENT WITH RESPECT TO NhII T THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, "i HE INSURANCE AFFOROL "•D BY THE POLICIES DESCRISED HEREIN 19 SUBJECT TO ALL. THE TERMS,
<br />E;CCLUSIONS ARID CONOIYIOMS OF SUCH POLICIES. LIMITS SHOVNN MAY hIAVE BEEN REDUCED BY PAID G.gIMS.
<br />POI PF POL ,(P
<br />LIMITS___
<br />tm ^_E tlf IN15URAAICC I�y^c,W „•_„ PGLICY NUMBER„ NINV IYVW NIIWI
<br />GENERAL LIABILITY ?AACCCURRENC'r _ 0 7=00 D1 DO
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<br />7L' COf.IMEP.CIAI GENERAL LPBILfPr i ^ES E9 occ I P S DO , DO
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<br />PERSCNAL & AD'ONJURY 5 1,000,00
<br />GENERAL A,� GORBOATC_ 1 2,000,00
<br />GENt AGGREGATE.
<br />P Lnh Ir AP PER: P OOLCTS- C 0.UPLIES PJoPAOG s 2,000,00
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<br />OLICYII„�n- RO• n L. CC - COMBINED •SNQLb L. IT
<br />_ ANTOMOBILE LIAaILIN I _. ES q nlCmnN _ I INCLUAE
<br />TO I EOOILY IIN,IURY(Par w3an)
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<br />M' ALL OWNED SCHEDULED aT lu2EP07129084868 4/1/2015 /1 /20;.0 2GOILY INJURY (Par 5CCitl9np 1
<br />AUTOS AUTOS PROPERTY ALIAGE
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<br />DESCRIPTIONO.srD, imilll CITY IA NA IS :C09,AUDED01 Rm,nmrha SCNvWUIa, If mvn J15US ragvnl SO
<br />IT IS AQ$tE'ED TBNi' CI'T'Y OF 5R.tTTI,A ,pittA IS .CL`YOLUDED NS ADDITIOIMAL IJ.NSTJRtF'D 90LE2,Y AS TE'ri lxt IlN'TERE /SiS MAY
<br />:AP2EAEi Iii? ACCO:eiO,'A:VOE WITA 'TirZ, PROVISIONS OF TEE' POLICY' FORM. y¢ /�,,'y�UC> /g�� /ry9]5
<br />�—+ A N
<br />CITY OF SADPIkn ANA
<br />ro Box 1964
<br />SANTA ANA, CA 9270:2
<br />SHOULD ANY CF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTIOE WILL Be CELIVER4D IN
<br />ACCORDANCE WITH THE POLICY PRWASION9.
<br />at. IHtt=tin /CENTSE
<br />INR02's "Mrns, n. The &r:(TOR rvamm a nel Inns aen rvenieaasor7 wto rGc of Ar:nri'
<br />resented.
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