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<br />"W' <br /> <br />A - 2-00;>- - j~) <br /> <br />..." <br /> <br />ALLSTATE LIENHOWER SERVICE CENTER <br />PO BOX 660349 <br />DALLAS, IX 75266-0349 <br /> <br />APPROVED AS TO FORM <br /> <br />,~~ <br /> <br />Laura Sheedy <br />Oeputy City Attorney <br /> <br />11.1....1.11,..111"",.11.1,,111"1,..1111"'1,1.111....1,,11 <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLZA <br />SANTA ANA CA 92701-4010 <br /> <br />Date: 06/06/02 <br /> <br />CERTIFICATE OF INSURANCE <br /> <br />ALLSTATE INSURANCE COMPANY <br />Northbrook,I1linois, certifies that the following insurance is in force: <br />POLICYHOLDER POLICY NUMBER <br />RALPH FERGUSON 02448250901104 <br />1720 ADMORE APT 121 <br />HERMOSA BEACH CA 90254-3028 <br /> <br />EFFECTIVE DATE <br />OF CERTIFICATE <br />JULY 4, 2002 <br /> <br />POLICY PERIOD <br />JULY 4, 2002 <br />JANUARY 4, 2003 <br /> <br />A1Ll:01A.M. <br />St...ml.udTime <br /> <br />The person or organization designated below is described in the policy as: <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLZA <br />SANTA ANA CA 92701-4010 <br /> <br />@ LIENHOLDER <br />(Loss. Payable Clause) <br />X ADDITIONAL <br />INTERESTED PARTY <br />RICHARD E WEBER <br />(310)376-0231 <br /> <br />AGENT <br />PHONE <br /> <br />Coverages designated below are afforded for each described vehicle: <br />III $1,000,000 EAPERS,-$ 1 ,000,000 EA,OCe. 1992 LEXUS <br />PD $50,000 EA,OCe. JT8VK13T8N0069097 <br />Collision- $500 DED, Comprehensive- $250 DED, <br />BI $1,000,000 EAPERS,-$I,OOO,OOO EAOCe. 1995 TAURUS <br />PD $50,000 EAOCe. 1FALP57U2SG256039 <br />Collision- $500 DED, Comprehensive- $250 DED, <br /> <br />See rewrse side for provisions conceming Loss Payable Clause and Additional Interested Palty, <br /> <br />This Celtificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage <br />afforded by the policy referred to above, <br /> <br />DI697 <br /> <br />'BllI11Iiiilr~1~~lfiillllllllllll~IIIIIIIIII~~~1111111IIII~III~~II~II~I~IIII~II~ <br />