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<br />ACOB.Q. CERTIFICATE OF LIABILITY INSURANCE \ DATE (MMIDDNYYYI
<br /> 01/30/2009
<br />PRODUCER (925)688-0733 FAX (925)688-0737 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Westport & Associates Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />License #OB84505 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />1390 Willow Pass Rd., #930
<br />Concord, CA 94520-5253 INSURERS AFFORDING COVERAGE NAIC#
<br />INSURED Downey Vendors, Inc. / Ea9le Vendin9, Inc. INSURER A Travelers Indemn Company of CT
<br /> DBA: aka: Premier Vending Group INSURER S"
<br /> 6814 Suva Street A ,::200\ - o';+.5 INSURER c.
<br /> Bell Gardens, CA 90201 " " INSURER 0:
<br /> ,(1;)9\ INSURER E.
<br />cnV~RAr.E" . o;L5 ""
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS
<br />INSR ~Q.I!! TYPE OF INSURANCE POLICY NUMBER PPH.~Y EFFECTIVE POLICY EXPIRATION LIMITS
<br /> GENERAL LIABILITY 6601430C75209 02/09/2009 02/09/2010 EACH OCCURRENCE . 1,000,001
<br /> f-x COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED . 100 , 001
<br /> l CLAIMS MADE [!] OCCUR MED EXP (Anyone person) . 5,000
<br />A f-- PERSONAL & ADV INJURY . I,OOO,OO~
<br /> f- GENERAL AGGREGATE . 2,000,001
<br /> rl'L AGG~EnE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG . 2,000,000
<br /> PRO- n
<br /> POLICY JECT LOC
<br /> ~TOMOBILE LIABILITY BAH95C09509 02/09/2009 02/09/2010 COMBINED SINGLE LIMIT
<br /> (Eaaccidenl) .
<br /> - ANY AUTO 1,000,000
<br /> - ALL OWNED AUTOS -, 1\ BODILY INJURY
<br /> .
<br /> 0- SCHEDULED AUTOS "O~ (Per person)
<br />A
<br /> e! HIRED AUTOS r { BODILY INJURY
<br /> .' l7" .
<br /> 0- NON-OWNED AUTOS " (Peraccidenll
<br /> , . -,
<br /> " ,IL~
<br /> f- '--, PROPERTY DAMAGE ,
<br /> {' - (Per accident)
<br /> , .-
<br /> ~RAGE LIABILITY ~~J /I ~~"'~' AUTO ONLY" EA ACCIDENT .
<br /> .~~ '--C' r) I -,'
<br /> ANY AUTO " " EAACC .
<br /> ~'b-<;; (., OTHER THAN
<br /> 1// >> " AUTO ONLY AGG .
<br /> :=JESS/UMBRELLA LIABILITY CUP3619Y ~~ ['/09/2009 02/09/2010 EACH OCCURRENCE . 5,000,00<
<br /> OCCUR 0 CLAIMS MADE AGGREGATE .
<br />A . 5,000,000
<br /> ~ DEDUCTIBLE .
<br /> X RETENTION . 10 , 00< .
<br /> WORKERS COMPENSATION AND IACRUBI215L86708 04/01/2008 04/01/2009 1.;:(~,mT.~.1 IDJ~'
<br /> EMPLOYERS' LIABILITY E L. EACH ACCIDENT . 1,000,001
<br />A ANY PROPRIETOR/PARTNERfEXECUTIVE
<br /> OFFICER/MEMBER EXCLUDED? E,L DISEASE - EA EMPLOYEE . I,OOO,OOl
<br /> If yes describe under E L. DISEASE - POLICY LIMIT . 1,000,000
<br /> SPECIAL PROVISIONS below
<br /> OTHER
<br />DESCRIPTION OF OPERATIONS I LOCATIONS' VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECiAl PROVISIONS
<br />ity of Santa Ana, its officers, employees, agents, representatives & volunteers are named as
<br />dditional insured as respects to general liability subject to the conditions, 1 imitations
<br />ond;t;ons, limitations and exclsuions of the policy.
<br />10 Days notice for non-payment of premium.
<br />
<br />C
<br />
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAil
<br />*30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT,
<br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABILlTY
<br />OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
<br />AUTHOR E REPRESENTATIVE
<br />-cvacL<..,.... ~ -1It'
<br />@ACORDCORPORATION1988
<br />
<br />City of Santa Ana
<br />20 Civic Center Plaza, M-30
<br />Santa Ana, CA 92702
<br />
<br />ACORD 25 (2001/08)
<br />
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