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<br />tAœBQM CERTIFICATE OF LIABILITY INSURANCE I DATE IMMfDDfYYYV <br />08/25/2004 <br />PROOUCER (650)341-4484 FAX (650)341-4465 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Business Professional Ins. Assoc. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />1519 South B Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />San Mateo, CA 94402 <br /> INSURERS AFFORDING COVERAGE NAIC# <br />INSURED Valley Oak Systems Inc. þ..-lfffl-003 INSURER A Federal Insurance/Chubb Ins. <br /> 5000 Executive Pkwy., Suite 340 A- ¡¡'0(¡I.-~5 INSURER B Granite State Ins. Co <br /> San Ramon, CA 94583 -'t'~D0.3-o(,<¡ INSURER c: <br /> INSURER 0: <br /> INSURER E: <br /> <br />C E <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN <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 /> <br />INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION <br /> <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE 0 OCCUR <br /> <br />3582-10-16 PLE 07/28/2004 <br /> <br />LIMITS <br />$ <br />$ <br />MED EXP (Anyone person) $ <br />PERSONAL & ADV INJURY $ <br />$ <br />PRODUCTS. COMP/OP AGG $ <br /> <br />07/28/2005 <br /> <br />EACH OCCURRENCE <br />DAMAGE TO RENTED <br /> <br />A <br /> <br />GENERAL AGGREGATE <br /> <br /> <br />LOC <br /> <br />7499-64-69 07/28/2004 07/28/2005 COMBINED SINGLE LIMIT <br /> (Eaaccidenl) $ <br /> BODILY INJURY $ <br /> (Per person) <br /> BODILY INJURY $ <br /> (Peraccidenl) <br /> //2 PROPERTY DAMAGE $ <br /> (Peraccidenl) <br /> <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br /> <br />A <br /> <br />X ALL OWNED AUTOS <br />SCHEDULED AUTOS <br /> <br />X HIRED AUTOS <br />X NON-OWNED AUTOS <br /> <br /> <br />AUTO ONLY - EA ACCIDENT $ <br />EAACC $ <br />AGG $ <br />$ <br />$ <br />$ <br />$ <br />$ <br /> <br />GARAGE LIABILITY <br />ANY AUTO <br /> <br />OTHER THAN <br />AUTO ONLY' <br /> <br />EXCESSfUMBRELLA LIABILITY <br />OCCUR 0 CLAIMS MADE <br /> <br />7983-41-70 07/28/2004 <br /> <br />EACH OCCURRENCE <br />AGGREGATE <br /> <br />07/28/2005 <br /> <br />A <br /> <br />EXCLUDES PROFESSIONAL <br />LIABILITY <br /> <br />DEDUCTIBLE <br />X RETENTION <br /> <br />$ <br /> <br />10,00 <br /> <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />B ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />o;~ressional Liability <br />A <br /> <br />CA <br />PA/FL <br />MI/MD <br /> <br />10/16/2003 <br /> <br />x wc STATU- <br />E,L. EACH ACCIDENT <br /> <br />OTH- <br /> <br />WC 311-14-75 <br />WC 311-12-24 <br />WC 311-12-23 <br /> <br />10/16/2004 <br /> <br /> <br />1,000,00 <br />300,00 <br />10,000 <br />1,000,00 <br />2,000,00 <br />2,000,00 <br /> <br />$ <br /> <br /> <br />3,000,00 <br />3,000,00 <br /> <br />07/28/2004 <br /> <br />07/28/2005 <br /> <br />E.L, DISEASE - EA EMPLOYE $ <br />E,L. DISEASE - POLICY LIMIT $ <br />$3,000,000 <br />$50,000 Deductible <br /> <br />1,000,00 <br />1,000,00 <br />1,000,00 <br /> <br />3582-10-16 <br />(EXCLUDED FROM EXCESS <br />LIABILITY POLICY) <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />he City of Santa Ana, its officers, agents, employees, and volunteers <br />'n respects to insureds business operations. <br /> <br />are named as Additional Insureds <br /> <br />dditional Insured applies to General Liability policy only <br />10 day notice of cancellation for non payment of premium shall apply. <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ~~ MAIL <br />JL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />~~II!IJ0IItXi1llX>1lXIUIOOXJ(XX <br />IOOOOOOOOIJIj(JOOOO(¡)IIII(ItXXIOOtXIJ(~XXXXXXXX <br /> <br />City of Santa Ana <br />Jeff Stevens- Risk Mgr. <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br /> <br />AUTHORIZED REPRESENTATIVE <br /> <br />~~- <br /> <br />@ACORD CORPORATION 1988 <br /> <br />f'vU}- <br /> <br /> <br />ACORD 25 (2001/08) <br />