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Certificate of Insurance 1 of 1 #M81695 COVERAGES: THIS IS TO CERTIFY THAT 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR TYPE OF INSURANCE POLICY NUMBER EFF.DATE EXP.DATE A GENERAL LIABILITY Agency Name and Address: THIS CERTIFICATE IS ISSUED AS A MATTER OF Professional Practice INFORMATION ONLY AND CONFERS NO RIGHTS UPON Insurance Brokers, Inc. THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES 2030 Main Street, Suite 350 NOT AMEND, EXTEND OR ALTER THE COVERAGE Irvine, CA 92614 AFFORDED THE POLICIES LISTED BELOW. Combined Single Limit: $1,000,000 Insureds Name and Address: Dahl Taylor & Associates, Inc. Companies Affording Policies: A. United States Fidelity & Guaranty Cc B.St. Paul Fire & Marine Insurance Co. 2960 Daimler Street C.Continental Casualty Company Santa Ana, CA 92705-5824 D. Each Occurrence: E. Aggregate: F. Statutory Limits COVERAGES: THIS IS TO CERTIFY THAT 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR TYPE OF INSURANCE POLICY NUMBER EFF.DATE EXP.DATE A GENERAL LIABILITY BKO1885006 09/01/04 09/01/05 $2,000,000 Commercial General Liability $1,000,000 Each Occurrence: $1,000,000 Fire Dmg. (any one fire): ❑ Claims Made Combined Single Limit: $1,000,000 Bodily Injury/person: $0 ® Occurrence $0 Property Damage: $0 Each Occurrence: ❑ Owner's and Contractors Aggregate: $1,000,000 Statutory Limits Protective $1,000,000 Disease/Policy Limit: $1,000,000 Disease/Employee: $1,001 Per Claim $1,000,000 Aggregate A AUTO LIABILITY BKO1885006 09/01/04 09/01/05 ❑ Any Automobile ❑ All Owned Autos APPROVED AS T 'UIa� ❑ Scheduled Autos X❑ Hired Autos Non -owned Autos La rB Slit[ Sh El Garage Liability ❑ Assistan City e orr ey A EXCESS LIABILITY BKO1885006 09/01/04 09/01/05 N Umbrella Form ❑ Other than Umbrella Form B WORKERS' BWO1878414 09/01/04 09/01/05 COMPENSATION AND EMPLOYER'S LIABILITY C PROFESSIONAL AEA113969319 05/06/04 05/06/05 LIABILITY' Description of Operations/Locations/Vehicles/Restrictions/Special items: 'Written at acarenate limits of liahility not less than amount shown POLICY LIMITS General Aggregate: $2,000,000 Products-Corn/Ops WITHIN THE POLICY FOR ALL OPERATIONS OF THE INSURED. Aggregate: $2,000,000 Personal and Adv. Injury: $1,000,000 Each Occurrence: $1,000,000 Fire Dmg. (any one fire): $500,000 Combined Single Limit: $1,000,000 Bodily Injury/person: $0 Bodily Injury/accident: $0 Property Damage: $0 Each Occurrence: $1,000,000 Aggregate: $1,000,000 Statutory Limits Each Accident: $1,000,000 Disease/Policy Limit: $1,000,000 Disease/Employee: $1,001 Per Claim $1,000,000 Aggregate $1,000,000 $0 Certificate Holder: THE AGGREGATE LIMIT IS THE TOTAL INS U RANCE AVAILABLE FOR CLAIMS PRESENTED WITHIN THE POLICY FOR ALL OPERATIONS OF THE INSURED. exclusion verification saved in CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE EXPIRATION Word DATE THEREOF, THE ISSUING COMPANY, ITS AGENTS OR REPRESENTATIVES WILL MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, EXCEPT IN THE EVENT OF CANCELLATION FOR NON-PAYMENT OF PREMIUM IN WHICH CASE 10 DAYS NOTICE WILL BE GIVEN. cc: Authonzed Representative: 08/13/04