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!.bie of Californill - Ca.hftlmi... i:.rwirollll'\enlal rmleolOTl ,l..itency , , CERTIFICATE qF INSURAN.CE FOR PUBUC LIABILITY COVERAGE i D~partm:nl of i C~I'= SLlb~lant:!s Con~-o! . T /';\tf1SPlma'liOJ:! t!t:1t aSttO Cal C-ehter'o;j'v~' Sacr.:mer.Io. C.A. l?S!ii's.3<:DO (91.5) ~SS-43:;~ fPl.ME OF INSURED: " trriited Storui Water, Inc. , j 'ADD~SS.:.. 14000 ~. VALLEY BLVD. CA 91746 i CERTIFfCATION' ThE! authorize(1 signature below certifies tl't~t (a) each policy of insutan~ listed below has beel1 i."ue.d 10 !he insured named above: anl1ls lr't fon:e at this Ume and rb) each polil;:)' so listed PROVIDES YE;HlCLE LIABILITY COVERAGE FOR "PUBUc LIASIUTY" . WHICH INCLUDES LiABILlT'Y FOR ""BOdILY INJURY," "PROPERTY DAMAGE" AND ~ENVlRONMENTA.L RESTORA'nON"' . PURSUANT!O SECTION 25169 O~ THEIC~U:'OR':llA ~EAl Tt:f AN~ ~~FEl"Y CODE wiLti respect to t/'le.OPEra~on, maintel'1ance or ' use bY the n;;!l'r1ecl il1$ured or 31"1y v~~t1c::le for ....tJlch regIstration or 3utnonZ;<Ihol'l 10 transport hazardcl,l'" wasle IS required by the Department of ToX,ic Substances. Control o~ the S[ale of California regardless qr whether such vehicles are specifically described in the policy. ' I I p~IMARY INSU~ANCE - COM81!\lEO SI~GLE UM'. EFFECTfVE D.o. n~ OF INSURANCE POLICY NUMBER: j BAP 5258433-02 COVERAGE: . . i 11-16-05 I INSURANCE COMPANY NAME: T ADDRESS: 801 N. "'BRANp BLVD.tE TELEPHONE .NUMBER: ZORICH AMERICAN"INS. CCKPAAf GLENDALE, CA 91203 (818) 347-5679 This policy provides c:ov~ge fQr public: liability indlJding bOr1i1y injury, properry dam_S@ arll:f enviro.nm~ntaJ re;s;loration for the amoUnl of S 1,000,000. ! in aCCOrd.ll'Ice 'with languOlge c:onsistent with a Ml;::S-90 -endorsemenl EXCESS UABIUTY INSURANCE INSURANCE POLICY NUMBER: SED 5258438-02 EFFEcnVE DATE OF COV.E.RAGE; 11-16-05 INSURANCE COMPANY !\lAME: ADDRESS: TELEPHONE NUMBER: ZURICH AMERICAN INS. CXl1PANt , 801 N. BRAND BLVD., iFH (818)347-'5679_ n,is p,olicy provides coverage lor' amounts i? e:x;c~s otlhe primary jasurance for public: tiab~lity including bt>dily injury, property damage and environman~1 restoration for the amQun! of S 4,UOO,00Q In a~t:>>rdanc6 \'\lith languC!ge consistent with a MCS-90 endorsemenl ! j '. . CANCELLATION ENDORSEMENT The authorized signature below warrants ao~ guarantees thaI eac::/'l inSurance policy for whicl1 this Certificate of lnsur;mce ;s issued is effective until t:;;il'lceled or e~ired; and, suc::ri policy l:OVe;ag~~afJ remain in 'fUlllCLrce-.:aClcieffec:LuntiLtI?-e..1h;tti~t/'l~}-Say-aI'tf;r ~ ---':"Notioe-of-earn:dt~jorrtn wntin9 rs gIVen onoehalfOf the rni~ranca Company to the D~plJ11ment of To)cic Substa~ce:. Control. The thirty (30) day period is 10 C::OlJ'lmence from t~e date the NI?[ic:e of Canr:elfS!ticn is provided to t/'Ie Depat1mel'l[ of Toxic Substances . €;oQntrol. T (an.!opCrt..tion ~l1il : I. . Thi$ Certificate of Insurance and any Notice of Cancenation are proparly liIed by mailing, postage p::r;d. to the Departms"t of TO:QI; Sub~tances Control, Transportation Unit, 88aO Cal Cente.r.Drive, S<lc:ramento, C~firornia 35826-3200. . 'I . . .. ,I AUTHORIZED SIGNATURE r HeREBY CERnrr tinder pert;,rty of law that: (a) all information prollided'is trtJe and correct, and (b) either the I~surance Company is ClQrnitted by, the Depanmenl or 1n.$uranCEl in !the Slate of California to Write the listed insurance poljdes OR. if nOriJdtl"litt~d;, I am ficansed by the Califo " Depanmenl o( It'ls~iance as a -Surplus Une& Broker" authorized 10 represent the n:Jmed Insurance Co~pany in making Ulis t:eJ1ifi ion. I . . . . -ep G~ TUR~nature in c:o'ntrasnl"lg C:iJlcr ink) DATE 51 GNED: ' ~ L~ I OS/24/,?-005 o cnE:. (PleQse print or type) I SURPLUS LINES BROKER NO. [If appJlt:able); . I U ~ ! COMPANY. NAME: . j ZORICH AMERICAN INS. cxm>ANt SIGNER'S COMPANY ADDRESS: 801 N. ~ BLVD., iFH I I , I j5-:f I'. (OEFrNmONS USED IN nus CERTIFlCA.TE OF INSU.RA~~E A~~ S~OWN ON THE ~,EVEi5:~E. S~E OF rHl~ FORM.) D~C'03alfronllf71Q:Z\ .' 'I ":..~,~iL~,:~:~:'~~:'h':::::+~?~:~~~.':,>' '~',:i.st>-iSl~'" . "Cd::C\~ -.