SAFETEC COMPLIANCE SYSTEMS, INC. 1 - 2012

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OP ID: EF CERTIFICATE OF LIABILITY INSURANCE 7071l7/(MMIDDIYYYY) 12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER 360-695-3301 CONTACT NAME~ Biggs Insurance Services P HONE FAX P.O. Box 189 360-696-2232 NC No: 916 Main Street E-MAIL Vancnuver, WA 98666 ADDRESS: Richard Biggs PCUSTOMER RODUCER SAFET-2 INSURERS AFFORDING COVERAGE NAIC # INSURED Safetec Compliance Systems Inc INSURER A: Federal I n s u rance Com an 7700 NE Parkway Dr #125 INSURER B: Best Rating A++ Vancouver, WA 98662 INSURER C: INSURER D: INSURER E: [INSURER F' COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP POLICY NUMBER )DNYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X 35814269 06101/12 06/01/13 PDAMAGE TO RENTED REMISES Ea occurrence $ 1,000,00 CLAIMS-MADE r-xl OCCUR MED EXP (Any one person) $ 10,00 X Vendors Liab Incl PERSONAL & ADV INJURY $ 1,000,00 X WA Stop Gap GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMPIOP AGG $ 1,000,00 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1'000'00 A ANY AUTO 06101112 06 (Ea accident) (01/13 70206213 BODILY INJURY (Per person) $ ALL OWNED AUTOS ' BODILY INJURY (Per accident) $ SCHEDULED AUTOS . PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS - $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,00 EXCESSLIAB XCLAIMS-MADE AGGREGATE $ 4,000,00 A 99473421 06/01/12 06/01113 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS' LIABILITY Y I N TORY LIMITS R A ANY PROPRIETOR/PARTNER/EXECUTIVE 71735446 06/01112 06/01113 E.L. EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? ? N I A (Mandatory in NH) E.L. DISEASE -EA EMPLOYE $ 11000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00 A Professional 35814269 06/01/12 06101113 E & O 5,000,00 Info/Network E&O Ded. 25,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder, its officers, agents and employees and representatives ( Addl Insureds/Vendors) are automatically included as Additional insureds and a Waiver of Rights form is included in the policy form and 80-02-2367 attached. CERTIFICATE HOLDER CANCELLATION CITY052 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Purchasing Department 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 Z! - ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD