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FEB-16-2006 14:57 FROM: <br />TO:714 647 5311 P.313 <br />_. <br />DRIVER -ALLIANT <br />License Number: 006861 <br />Phone (949) 756-0271 / Fag (949) 7S&2713 <br />CcrtifcaleNumber.035 <br />Date: 219/06 <br />VENDOR/CONTRACTOR LIABILITY PROGRAM <br />Named insured <br />VIDIiOCNGINEF,RTNGSERVICES— THOMASE.BYSTRY <br />Address: <br />3058 NORTH W ESTHAV EN ST. <br />City/State/Zip: <br />ORANGE, CA M65 <br />Additional Insured! <br />CITY OF SANTA ANA <br />Contract Term: From: <br />02/01/06 TO 02/01/07 <br />Description of Contract: <br />VIDEO PRODUCER <br />Contract Amount' <br />S63,600 <br />COMMBRCIAtCENERAL-LIARM]I 'Y—NEW-OCCURRENCE-FORM <br />General Aggregate: SI,000,000. <br />Products/Completed Operations Limit: S1,000,000. <br />Personal Advertising: S1,000,000. <br />Each Occurrence: S1,000,01)0. <br />Fire D.uwge: S 50,000. <br />Medical Payments: S 5,000 <br />IMPORTANT! <br />Coverages are Limited to described couIIxt. <br />DEDUCTIBLE: $1,000. Each Claim, Including Legal and Adjustment Expenses <br />ANNUAL PREMIUM: S1,902,00 Fully Earned at Inception <br />SURPLUS LINES TAX: S 60.39Fully Famed at Inception <br />POLICY FEE: S aN Fully Famed at Inceplim <br />TOTAL $2,012.39 <br />COMPANY: COLONY INSURANCE COMPANY <br />THIS COMPANY BINDS THL KIND(S) OF INSURANCE STIPULATED HEREON. THIS <br />INSURANCE IS SUBJECT TO THE TERMS, CONDITIONS, AND LIMITATIONS OF THE POLICY <br />`OFMASYE-R-POLIC't"L33092131SSUE0'7-0-VBNDCRWE)NTRACTf)RS-L1ABL•tT-YGROUP—. ^ -- <br />COPY OF THIS POLICY IS AVAILABLE ON REQUEST. <br />THIS CERTIFICA rE MAY BL CANCELLED BY THE INSURED BY SURRENDER OF THIS <br />BINDER OR BY WRIT17EN NOTICE TO THE COMPANY STATING WHEN CANCELLATION WILL <br />BE EFFECTIVE. THIS CERTIFICATE MAYBE CANCELLED BY THE c omPANY BY NOTICE TO <br />THE INSURED IN ACCORDANCE WITH THE POLICY CONDITIONS. <br />AUTHORIZED SIGNATURE/COUN7ERSIGNATUPE <br />R.E.C14AIX&ASSOCIATES INSURANCE BROKERS,INC. <br />I immc Numb". 0726211 41 CorP"ae Park. Suite 310, Irvine, CA 92606 <br />M"E(9e9)72241771 FAX (949)722A172 <br />