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pot OS 04 11:49a <br />p.2 <br />Bryan Hrannnn / „~I ~~~~ 714-964-8936 <br />CORD CERTIFICATE OF LIABILITY INS_U17ANCE <br />PRODUCER (31U)d32-5311 ~ FAX (3111)832-8024 THIS CERTFICATE ss ISSUED AS A MATT! <br />Inwrance [enter Associates ONLY 4ND CONFERS NO WGHTS UVON T <br />Harbor Insurance Agenc HOLDER 7}415 CERi1FK:ATE DOES NO7~ A <br />Y ALTER THE COVERAGE AFFORDED BY TH <br />1622 5. Gaffey PO Box 671. <br />SaR Pedro, G 90733--0671 INSURERS AFFORDING COVERAGE <br />IusuReD et Care Vacc net on Services ~ HS'up=RS American Economy Inwrance <br />10075 SparrDw Ave. Mn'~ ~,~f [^~~ ^~~ IlruuRER B. -.--~~~ .--- <br />Fountain Va71eY, CA 92706` vv ~EH C. -~~_---~ <br />WSUR°R b <br />~~~It y <br />rnveeer_E:a <br />DATE (YRODfI/Yn <br />NAIC # <br />THE P CLICIEG OF INSURANCE LISTED EELCN/ HAVE 9EIN LASUED TO THE NSURED NAMED ABOVE FOR THE POLICY PERgD RJDICATED. Pql W RHSTrW DINT <br />PNY R FOUIREMENT, TERM OR CONORgN OF ANY C(%JTRACr CR OTHER DOCUMENT WRH RESPECT TO WHICH THLS CERT!FICA"E MAV BE ISSUED OR <br />MAY P ERTAIN, THE 1NBURANOE AFFORDED BY THE PGLI(:IES .ESCRIBED HEREIN LS SUBJECT 7tl PL'_ THE TERMS. E%CLi131CN5 AND CONCfTON9 OF SUCH <br />POLIC ES. AOGREGA7E LIVRB SHOWN MAY F41VE 6EEN REOUCF_D BY PAD GJJMS, <br />INER TYPE Of INYDRAMCE _ PoLIDy We1ELR iGE[CTI1![ pp1 Y WM ~ LMITS _- <br /> DEMERK Mp411T' 02-Po-73fi437-6 3U/15 J2004 10/15/2005 EACH OCCURRENT s i 000 <br /> X COMMERpAI GENEP <br />A' <br />L <br />'S <br />PILT' MMAGETO RENIED S SO, <br /> ( <br />~ <br />~ <br />~ <br />~CLRIM4MAOF. IA ItX7.:UR MEDEiF (Airycrw pSrwnl E 1D, <br />t <br />1 <br />A ~ <br />__ <br />PERSONALBADV IKIVRY S 1 DQB, OO <br /> __ __ _ OFSIERAL Pt.CRIECr1iE S 2,000, <br /> (:EY1 ATa:aRE <br />WiE lA11TApPLE3 PER egbpUC{y_CpIpPIOPA(xi S S <br />OOO <br /> r <br />, <br />X PDIICY 1 ~ ~~ LOO -- --- t_ <br />Y <br /> Au r-MDa LE LuYUYY _ <br /> sWBLE Uart <br />uB< <br />E <br />D <br />~ i <br /> ANYAVro IO <br />iI <br />i <br />(F <br />p <br /> ALI OWNF.DAUTOS ___-______ ____~,,,_ <br /> flODRY ~}IJUNY S <br /> 3CNEWCEC AJT05 i t P Cepn) -- - <br /> <br />HIRED NUTJ.4 - <br />-_ _ <br /> 90011Y INJURY E <br /> NgV-0NNED HUIUS U~rE ~INm) <br /> °ROPERtt DPMA(iE - ~~ <br /> S <br /> <br />_- rPeraromnt) <br /> DARADE LIA9UTY AUPOOHLY-EA ADCCENT i <br /> ANYpUlO EAACC <br />OTNEN T?lVr S <br /> <br />AUID MLY. AGG _ <br />f <br /> ERCEENUYERELLADWDTY EPOH IXTLRREW.E i <br /> OOCUR ~QAWSN.IDE Af.Y,RE(eA e' S <br /> <br />--~i-~ E -_- <br /> I - DEDUTBLF ~____._., <br />- i <br /> <br />_L <br />0.ETENTgN i <br />_ _ <br />S <br /> WDRRER6 COBMN[ATDN AND <br />fiMPLOYERr LEEaIITY ~~ xw,oC STAT~TT <br />~~~~~ <br /> <br />ANY PROPRIFR%NPApMEPoEXEOUME <br />F..L EACH ACCIDENT _ <br />i <br /> <br />O <br />P <br />FICEItMEMaQi E%C'_L'DEGi _____ <br /> v <br />y EL.GSEASE-FA EMPLO"E i <br />----- <br /> SPECUt PROIISICNSbNVw .. E. L. OBEASE _POLICY'JMIT E <br />__~.____ - _ -_ <br />OT01 ~ <br />~~~ <br />OE[C ON6aP6M /L --FErppISCiEE/ti~CAWIOIa AGED BY ESpWe01EMTl SV~O PIIOVI99V8 <br />ert~~''i pte no~d°N"er is names <br />l i <br />tleiti <br />i <br />d <br />h 1 <br />Y~ <br />as a <br />ona <br />nsure <br />W <br />t <br />te <br />lity lieritdd to claims arising out of <br />Ilsured's operations only, with no assLelpt; on of liabi7l ties to others. <br />1U Day Notice for Non PayRnent. <br />ee policy for terns and caiditions. <br />R <br />A <br />R <br />I f. <br />Ti <br />[F - <br />-- T NOI DER AN eTION <br />City of Santa Arta <br />FO Box 19dd <br />Santa Ana, U 92712 <br />ACUflD 26 [I0011f18~ FAX: <br />•NCIULD Y1Y MINE ABOVE CER1':pINED/M)UCIFJ EE CJINCktLE- NF.FORE lHE <br />FJLMRATOR MIE TNEREM, TIE Rl]UIND meURER MLL ENDEAVOR TO NWL <br />;D• pgygMgTiEN IgTICENTIE C4RTAC'ATE 1R)L-Ep NAIED Tp TIE LEFT, <br />BUY FYLI.RE IO WYL 9NCN IgTICE BN4L IYFOSE NO OBIiOATgM OR LWLILLIY <br />taACURD GURPURATION 1988 <br />