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tAœBQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYVY¡ 08/25/2004 PRODUCER (650)341-4484 FAX (650)341-4465 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Business Professional Ins. Assoc. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1519 South B Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. San Mateo, CA 94402 INSURERS AFFORDING COVERAGE NAIC# INSURED Valley OaK Systems Inc. Iv I ffl-oo 3 INSURER A. Federal Insurance/Chubb Ins. 5000 Executive Pkwy., Suite 340 A- ¡¡>.oQ;I.- 0.35 INSURER B" Granite State Ins. Co San Ramon, CA 94583 "t- ~ 00.3 -0(,9 INSURER c: INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DO' TYPE OF INSURANCE POLICY NUMBER PRHi~ EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY 3582-10-16 PLE 07/28/2004 07/28/2005 EACH OCCURRENCE $ 1,000,00C X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,00C I CLAIMS MADE [K] OCCUR MED EXP (Anyone person) $ 10 ,OOC A PERSONAL & ADV INJURY $ 1,000,OOC - 2,000,00C GENERAL AGGREGATE $ - GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS. COMPfOP AGG $ 2,000,00C I ,nPRO. n POLICY JECT LaC AUTOMOBILE LIABILITY 7499-64-69 07/28/2004 07/28/2005 COMBINED SINGLE LIMIT - (Eaaccident) $ 1,000,00C ANY AUTO X ALL OWNED AUTOS BODILY INJURY - $ SCHEDULED AUTOS (Per person) A X HIRED AUTOS BODILY INJURY X $ NON-OWNED AUTOS Of} "¿r. (Per accident) -"- '~ /h- PROPERTY DAMAGE - ~c ~\V1 I (Per accident) $ ~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EAACC $ AUTO ONLY: AGG $ :==JESS/UMBRELLA LIABILITY 7983-41-70 07/28/2004 07/28/2005 EACH OCCURRENCE $ 3,000,00C OCCUR 0 CLAIMS MADE AGGREGATE $ 3,000,00C A EXCLUDES PROFESSIONAL $ ~ DEDUCTIBLE LIABILITY $ X RETENTION $ 10,00C $ WORKERS COMPENSATION AND CA WC 311-14-75 10/16/2003 10/16/2004 X I WC STATU., I IOJ~' EMPLOYERS' LIABIUTY PA/FL WC 311-12-24 l,OOO,OOC B ANY PROPRIETORfPARTNERfEXECUTIVE EL. EACH ACCIDENT $ OFFICERlMEMBER EXCLUDED? MI/MD we 311-12-23 E.L. DISEASE - EA EMPLOYEE $ 1,000,00C g~Ëêil~Lsp~'õvïš?åNS below EL. DISEASE - POLICY LIMIT $ l,OOO,OOC OTH'f.. Liability 3582-10-16 07/28/2004 07/28/2005 $3,000,000 ro esslonal A (EXCLUDED FROM EXCESS $50,000 Deductible LIABILITY POLICY) DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS he City of Santa Ana, its officers, agents, employees, and volunteers are named as Additional Insureds .n respects to insureds business operations. dditional Insured applies to General Liability policy only 10 day notice of cancellation for non payment of premium shall apply. City of Santa Ana Jeff Stevens- Risk Mgr. 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL 1I'rUX~ MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ~~(I(IIIIIJ0iIt(¡1liXi1lXIIIII¥«J(XX IOOOOOOOOIJIj(~IiI(ItJ{XIlOOt{II(IIØXIOOOOUOO(XXXXXXXX AUTHORIZED REPRESENTATIVE QQ,.~ - Debbie Uland SANDEE ACORD 25 (2001/08) @ACORDCORPORATION 1988 ¡.M}