Mar 17 05 11:12a Boas & Girls Club Of Sant 714 - 565 -1099 P.2
<br />t
<br />Q t a A' �C'1A/ - /PnhS�, Numher Oats BnExM' 3 /16/2005
<br />A-_ CQR-D.. CERTIFICATE OF LIABILITY INSURANCE = "716/ "'
<br />PR09Um ggqpfxtsousm zmmeramce soxvIces
<br />22912 Pacific Park Or 6200
<br />A11ao w_sie, CA 92656
<br />(949 )215-5&31
<br />123 456
<br />THIS CERTIFICATE 15 ISSUEO AS If MATTER OF 81FORNATION
<br />ONLY AND CONFERS NO RWIT3 UPON THE OER'TCAOR
<br />AL�TERRTTHE�ITIQCSOYCERTIFICATE � �, THE POLICIES GELOW.
<br />INSURERS AFFORDING COVERAGE
<br />NAIC•
<br />Room be" c Girls Of Swtl Ana, CA 92103
<br />Soya 6 6i.rls Of Septa An& Youndatien
<br />950 W. Highland
<br />Banta Ana, CA 92703
<br />I49 AEAA AW16re le,araaea camp
<br />IMn
<br />agolaER S:
<br />i,nm6A C'.
<br />sM1ERALUARART
<br />CCMMgpZa aENSUL,,,,
<br />timEga
<br />1 /1/2006
<br />INSUA6R 6
<br />e1,0 ,
<br />cnawcv
<br />7HE POUCIES OF WSURANCE LSiTEO SELOW HAVE MMW MUEO TO THE INSURED NAARD ASOvE FOR7HE POUCY PERIOD INDICATED. NOTWITHSTANDING
<br />ANY REQUIREMENT. TERN OR CONDITION WANT CONTRACT OR OTHER DOCIM'AENT WON RESPECT TOMS6CH THIS CUMISCATE NAV BE ISSUED OR
<br />MAY PSATAN, THE NSURANCE AFPOADEO BY THE POVOES DEACIO0E0 HOREIN IS SWW OCT TO ALL THE TERMS. OtCWIIOVS AND OONOrt10NS OF sUCH
<br />pOUCIEs. A00REGATE IAITS MINN MAY HAVE SEEN REDUCED GY ROAD CLAMS.
<br />- -
<br />&eo9LR AeP or7N6.RR.E 0 ®asap FOLIO" u cARraLe9 avaa nE BrnR.++eP
<br />The city of a.Ota An,, She emu
<br />plE'OMItOA 1Ne ■eY116 ee11RR1 RNii 6l�a NAa 30 Pint mom
<br />Pom ReI 11R
<br />`
<br />1/1/2005
<br />me
<br />IMn
<br />Santa na, G 92702
<br />X
<br />sM1ERALUARART
<br />CCMMgpZa aENSUL,,,,
<br />6040798273 -05
<br />1 /1/2006
<br />K,
<br />e1,0 ,
<br />��
<br />Nwnl
<br />50,000
<br />.S,O
<br />0"mY
<br />wLd
<br />F1, 000, 000
<br />�
<br />.080,000
<br />am � T1UIaTAPPUE9IM
<br />NAOPA00
<br />.1,000,00LOC
<br />A
<br />X
<br />AerdLnru
<br />D4saRT
<br />AN/At/10
<br />AU OVONO M,OS
<br />w,EEattcoMRas
<br />INIEOAUTOE
<br />WWOM NOAUWS
<br />810- 0179Y247 -05
<br />1/112005
<br />1/1/200 6
<br />i
<br />Le LAM
<br />7 L, 000, oaoo
<br />aODlY9uuRr
<br />tAeP.wp
<br />eODLYINJURY
<br />mamwe" j
<br />i
<br />I�aAMAG<
<br />L
<br />RMN[IANKM
<br />A AWO
<br />T' AODOeHT
<br />f
<br />eOIERTNAEI FAALC
<br />AUTO OAI : AOO
<br />t
<br />I
<br />A
<br />�/
<br />X
<br />DwAL F-1 OU mm M,LF
<br />F1o,000
<br />- 5Y09 -
<br />APPRO
<br />1 /2oo6
<br />ED AS
<br />2
<br />O FORM;
<br />e oukhsm w
<br />0•T,
<br />P
<br />P
<br />RCMRR& CamammoM mID
<br />MIPADYERrummm
<br />AM' Pg01aC1OMIAApRAOLGUTAK
<br />OFNCiAANIaIlA EPrLUOF01
<br />A r.wLA, uMM
<br />9�ECMLPROWMONR
<br />' 3
<br />/
<br />,y �1.
<br />-a"
<br />E.L NAOFNT
<br />f
<br />- lAt9NPLOTR
<br />t
<br />r8 Stlt
<br />Cdy
<br />Ldr
<br />ELOIS6ASI -004= MO
<br />i
<br />ORION
<br />ey
<br />MaWPRA Of WRMDONP,LasATNPNt IYM1LTARtRRCLYaePP100 ®eY OrolraRSar, aPltYlPAO11elAR `
<br />pS: Csrtifimte Nolder is awed as additional insured as respect, Flee OperAtieeelaf the nenad inanred,
<br />crRrlPa:Ale 17WR:n
<br />- -
<br />&eo9LR AeP or7N6.RR.E 0 ®asap FOLIO" u cARraLe9 avaa nE BrnR.++eP
<br />The city of a.Ota An,, She emu
<br />plE'OMItOA 1Ne ■eY116 ee11RR1 RNii 6l�a NAa 30 Pint mom
<br />Redevelopment Agmar, Eta, Offiaere. Agate
<br />NoTO[ TO TaT QRIMCNpR N0.4a TIAIlO xt TNf UPI;
<br />ad Saployees CONG PM P.O. SP. Igoe
<br />Santa na, G 92702
<br />ARTNOeRONVNN6DNATWB
<br />', w ae�nMn e�ileeAM &TM1N AeRR
<br />ACORD 25 (2DDU00)
<br />E0 /To 39vd 302msj.Id3gm 60G9-GTZ -606 QZ:TT GDOZ /iT /EQ
<br />
|