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<br />~1..~!!!~!!!~:.JI\lmll.llllll;lllaJl&ijlllq~jllll~llillll'11Ill'llllrl!I~llllllt!l!illll:!'I!11!!111!11!~ljllllIll" o~Jd~%r;' ;;
<br />
<br />THIS BI1,jDERIS"A TEMPORARY INSURA'NCE CONTRACT, SUBJECT TO THE CONDITIClNSSHOWNo'NTHE'REVERsts'IDE OF THIS FORM
<br />PRODUCER I r~,~N~. ._.. (800) 420-0555 COMPANY 10'NOER"
<br />MUNICIPALITIES INSURANCE SERVICES, INC. ESSEX INSURANCE CCMPANY I 3955
<br />1920 E. 17th Street, Ste. 130 "^TO EFFE TlVO T';' "..pPlRATlO ."
<br />
<br />Santa Ana, CA 92705 01/04/01 12 :'01' Q{ I AM 01/04/02 E'\'2m AM
<br />~ PM ~ NOON
<br />I THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY
<br />PER EX~lRING POLICY':
<br />DESCRIPTION OF OPERAT10NSNEHICLESIPROPERTY [Including location)
<br />
<br />CODE:
<br />~~~~gr..~a l~.
<br />INSURED
<br />
<br />. - -- I SUB CODE:
<br />
<br />..
<br />
<br />Leisure Class InstrUctors and The city Of
<br />Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />
<br />~ercise and Health Classes
<br />Santa Per the attached list
<br />
<br />for City employees
<br />
<br />/
<br />
<br />::q~Q5!.~J~~$;:MM;@*tmIMmiUm!~H@H~}H[@m~mftmMJHTIml*nMmill~Mt~11t@l1~~[[m@tt~H~Jl1H~t[K@m~*mm@@tt1@trtfm;i;@ilitf:#&iM1jfgHMMf@@@UM;W;:!if:
<br />
<br />TYPE OF INSURANCE
<br />PROPERTY CAUSES OF lOSS
<br />= BASIC D BROAD D SPEC
<br />
<br />-
<br />
<br />COVERAGE/FORMS
<br />
<br />AMOUNT
<br />
<br />DEDUCTIBLE
<br />
<br />COINS %
<br />
<br />GENERAL liABILITY
<br />X COMMERCIAL GENERAL LIABI!..JTY
<br />:"?,: I CLAIMS MADE 00 OCCUR
<br />_ OWNER'S & CONTRACTOR'S PROT
<br />
<br />-
<br />
<br />Policy Number:3CE9267
<br />
<br />GENERAL AGGREGATE
<br />PRODUCTS. COMP/O? AGG
<br />PERSONAL &. ADV INJURY
<br />EACH OCCURRENCE
<br />FIRE DAMAGE (Anyone lirel
<br />M;;O EXP (Any OM p~'scnl
<br />
<br />RETAO CATE FOR CLAIMS MAD;;:
<br />
<br />AUTOMOBILE LIABILITY
<br />-
<br />_ ANY AUTO
<br />_ ALL OWNED AUTOS
<br />_ SCHEOULED AUTOS
<br />_ HIRED AUTOS
<br />_ NON. OWNED AUTOS
<br />
<br />-
<br />
<br />COMBINED SINGLE LIMIT
<br />BODilY INJURY [Per persoll)
<br />SODlI..Y INJURY [Per accident!
<br />PROPERTY DAMAGE
<br />MEDICAL. PAYMENTS
<br />PERSONAL. INJURY PROT
<br />UNINSURED MOTORIST
<br />
<br />AUTO PHYSICAL DAMAGE DEDUCTIBLE ~ ALL VEHIC:..ES
<br />I COLLISION:
<br />1 OTHER THAN COL.:
<br />~AGE lIASILlTY
<br />_ ANY AUTO
<br />
<br />-
<br />
<br />U SCHEDULED VEHICLES
<br />
<br />I ACTUAL CASH VALUE
<br />I STATED AMOUNT
<br />I OTHER
<br />AUTO ONLY.. EA ACCIDENT
<br />OTH::R THAN AUTO ONL.Y;
<br />EACH ACCIDENT
<br />AGGREGATE
<br />EACH OCCURRENCE
<br />AGGREGATE
<br />S::Lf.1NSURED AETENTION
<br />I ! STATUTORY LIMITS
<br />E..1.CI-l ACCIDENT
<br />DIS::ASE. POLICY LIMIT
<br />DISEASE. EACH EMPL.OYEE
<br />
<br />EXCESS liABILITY
<br />
<br />I UMBRELLA fORM
<br />1 OTHER THAN UMBRELLA FORM
<br />
<br />RETRO DATE FOR CLAIMS MADE:
<br />
<br />WORKER'S COMPENSATION
<br />AND
<br />EMPLOYER'S liABILITY
<br />
<br />SPECIAL
<br />COND1TJONSI
<br />OTHER
<br />COVERAGES
<br />NAME & ADDRESS '^"',M~!!f!f.!1i~YE ;X~ri' 'Ii ,'1Y'l~,i\Mi
<br />" , . "',,' . ,,"^', "~".,."."",^,,, .' " 1"..,Si\ '" .
<br />., ~' MORTGAGE: ADDITIONAL INSURED
<br />I ~ A.I. ~ A LOSS PAYEE
<br />, _ lOAN'
<br />MIchael Vigliotta 0
<br />Deputy City Attarne}
<br />
<br />,
<br />AUTHO~ESENTA~IVE ...-..
<br />
<br />~IU~ Carol A. Frost
<br />- ".""" .'
<br />.. ,.~"..,.~...........,......,~... ... ,,~....~. .n., , ,,,.......... >' (
<br />.......,..w......".........'''...,......Lw........."...,.....w, ."H<>",,' "" " ',' 'i,~." ",... 'R' "'.'.:""~ii':""'."I"1..0,.,.n..IO.eO'" '""r;"RS~ SID 'I '" ",' ,'1. AC~"'''' "nR"O""''''ON 1993
<br />ACORD!7S's'H2f9:'l1' "'" ", ' \ ,<< '+',wTedmPO.,.,,~.,.. .""'..,, ,.<, "",,,,,,. ",,, N nCv>o " 5'~n ., ~ ~"" "V ~ ""',.
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