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Fram. Cart Request At: G.S. Levine Ins. Svcs_ Inc. FaxID'. G 5 Levine Insurance To: Attn Tonia <br />Date: 10/182007 09:02 AM Page. 6 of 6 <br />ACORD_ CERTIFICATE OF LIABILITY INSURANCE OPIDPI D.rE""°°"Y.n <br />FABEK-1 10/18/07 <br />R THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />c. S. Levine Inaurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Services, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />10505 Sorrento Valley Pd. A200 ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW. <br />San Diego CA 92121 <br />Phone: 858-481-8692 Fax: 858-481-7953 INSURERS AFFORDING COVERAGE NAICO <br />Ixsc~wD IxsuRFRx RL Specialty Insurance Co. <br />NBII ERD <br />Scott Faaekae G Associates ~rvsuRERc <br />17777 Del Paso Drive xsuPERJ <br />Poway CA 92064 ,,,, <br />V lXE P011CIE9Gl IbllRANCCLiSrm DtrCW IV,'!E SEEN 1391f9 rD THE iNYJ PE-AMI® I.BOY£ FDR tHE PDHCYP=_RICV)IH](AlERN0Th1iH9TAXDIXG <br />FN'/ PEDXiPH.IEVr rEP4OR LYIXOrIDX D[AH/ fANrMG ORO!HEP WCVA1Exi WI'H REEP~i 0 \VHILX iF15 DERiIICAiE AUVDE IREIIEO DP <br />NTV PEPiAIN iFE INSJMACEPFFURCEJ9ViNE Po.IGES ]EGCPo6EDNEP5415 SDD£~! i] HIiXE i=RAG E%CLL40X6 M'DCGV.TTIDNS DF iVCF <br />W lF5 AGGIEGAIELIIAIIS9HDVM FUV IU\'=PFEN,ff OV,£DFY MID CINIAS <br /> Y EfffCriVE I NOILY RFIMriDX <br /> *E LxN-6VY1 r[laa'Rw\'YI <br /> PtlLrt1 <br />Ar+ <br />.FU ECN DCLIIPPENCE s <br /> . D.,LwGEm ExieD <br /> C]1.11AEPG0.ceneuL UAPUm PReAnEESIE,~.,,~~1 s <br /> ~ f uLl.,.lnoE a Da.'JR m.l <br /> _ <br /> A <br />µ <br /> 4^GREGAiE <br />GExF 4 <br /> GEA'l3(4GREGNiE VINi ISPLIES FfR Wd]ttt5-CDAN'OP ACG <br /> ~ P <br /> ca- <br />roues <br /> ronoxnsu,a..ur mAewco axc~ilmrt <br />~ a.r ~, s <br /> vIll `L <br /> <br /> LLWXF9 Nli]6 5DD~lV IXIJRV <br /> Peroe aml <br /> SCHE WLEC~ WiD3 <br /> <br /> iReDamr. mDLnnmwv <br /> rv.,.romml <br /> xaxarxEn ercr. I <br />I <br />wDPEAr ~AAwE <br />s <br /> w~.[ne m~ <br /> ixe~m, PL ID Dx\v-EA AmIDw~ s <br /> xuvx~n JrxER.Hnx <br />FA <br /> 41iG0XLY <br />tiC E <br /> xW2w\ <br />EF xY FLN GL'AIRPENIX S <br /> NL <br /> LLR [] CLAIA6 A'/DE <br />~ I.LGPE:/.iE 5 <br /> ~ G1~VLiaE 3 <br /> P=rENr DN \ <br /> 'NCeiAIIF lix- <br /> x i PYO iD RYLllrt6 ER <br /> PL]YFPe YAWiIV IkXI <br />-- <br /> PDPRIEmw[ARSnewuEwlrvE <br /> Ii~X,41E41BEPF%f..N[J? EL D14Ai_-FJ.EAIP.GVE_ 5 <br /> ~cnb uhr <br />IN PFCMEIDAS IeM <br />EL DISEA9E~POLIG",llllr <br />E <br />pR[R <br />A Professional DPA9606624 06/05/07 06/05/08 Claim/Agq $1,000,D00 <br />~~ Liabilit Ded $10,000 <br />, r`y ~6 q'l. F-©~~je,' <br />oESCP.rr~on of uh r~srEOCnnona~wmas~E-aaumoxa nooeu Pr ExooxsEllExr.srFUALrxolr~a~wu `f <br />J <br />+ <br />~Y <br />~(~ <br />Re: All Operations of the nametl insured. 1,j±i <br />Proof of Inaurance. <br />r <br />The City of Santa Ana, Its Officers, Employees Agents, Volunteers 6 / .'~ ~ _ <br />Sespreaentatives aze named certificate holders. __---- ~~ <br />+10 day notice of cancellation applies for non payment of premium. lIX ~ L ~,L , <br /> <br />rrmr¢IrnTC unl nco GANGELLATION <br />CITSAN- DDEDan of rxe.mx.xecRisEDrw~na ne c.xl.a~ED PEVOxE rxe F.nn.uux <br />City of Santa Arte rern ERrDF me swwxlxaussswlu~a\ 30*_ .swwlr,<x <br />Attn: Tonia 2erba Dice rorxE Cexnncare nomER xaxexrxmeieFr,- <br />20 Civic Center Plata (1420) <br />P.O. eox 1988 <br />92702 <br />Santa Ana, CA <br />ACORD 25 (2001/00) <br />