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<br />DATE (MMIDD1YYYY)
<br />07/09/2004
<br />
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />
<br />"nVE
<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 />'r'l~ ~g,~~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
<br />~NERAL LIABILITY 3582 -10-16 PLE 07/28/2004 07/28/2005 EACH OCCURRENCE
<br />X COMMERCiAl GENERAL LIABILITY DAMAGE TO RENTED
<br />I CLAIMS MADE [IJ OCCUR
<br />
<br />E.L. EACH ACCIDENT $
<br />~L. DISEA~ EA EMPLOY~~ $
<br />E.L. DISEASE - POLICY LIMIT $
<br />$3,000,000
<br />$50,000 Deductible
<br />
<br />~.
<br />
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />
<br />PRODUCER (650)341-4484
<br />Business Professional
<br />1519 South B Street
<br />San Mateo, CA 94402
<br />
<br />FAX (650)341-4465
<br />Ins. Assoc. Inc.
<br />
<br />.
<br />
<br />INSURERS AFFORDING COVERAGE
<br />INSURER A:. Federal Insurance
<br />INSURERB Granite State Ins. CO
<br />INSURER C.
<br />INSURER 0
<br />INSURER E
<br />
<br />'NSURED Valley Oak Systems Inc.
<br />5000 Executive Pkwy., Suite 340
<br />San Ramon, CA 94583
<br />
<br />.~
<br />
<br />$
<br />$
<br />$
<br />$
<br />$
<br />PRODUCTS - COMP/OP AGG S
<br />
<br />MED EXP (Anyone person)
<br />
<br />PERSONAL & PIN INJURY
<br />
<br />GENERAL AGGREGATE
<br />
<br />A
<br />
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />~ POLlCy-n r~8T -- n LaC
<br />~TOMOBlLE LIABILITY
<br />_ ANY AUTO
<br />~ ALL OWNED AUTOS
<br />SCHEDULED AUTOS
<br />f.-cc
<br />~ HIRED AUTOS
<br />~ NON-OWNED AUTOS
<br />
<br />I-
<br />
<br />PROPERTY DAMAGE
<br />(Per aCCident)
<br />
<br />07/28/2005
<br />
<br />7499-64-69 07/28/2004
<br />
<br />COMBINED SINGLE LIMIT
<br />(Eaaccident)
<br />
<br />BODILY INJURY
<br />(Per person)
<br />
<br />,\
<br />
<br />j \ '-. " '.
<br />
<br />, \J '.,.~;
<br />
<br />BODILY INJURY
<br />(Per accident)
<br />
<br />,_._,~, ~,{/~
<br />t=._~ ___
<br />r.,/L '.v
<br />\i[ 'f[lL'Y
<br />
<br />A
<br />
<br />M~GE LIABILITY
<br />H ANY AUTO
<br />
<br />~ESSIUMBRELLA LIABILITY
<br />-.--J OCCUR 0 CLAIMS MADE
<br />
<br />I DEDUCTIBLE
<br />xi RETENTION S 10, OO(]
<br />
<br />/\',",.,[,
<br />
<br />;j' ;
<br />
<br />AUTO ONLY - EA ACCIDENT $
<br />$
<br />$
<br />$
<br />$
<br />$
<br />$
<br />$
<br />
<br />OTHER THAN
<br />AUTO ONLY
<br />
<br />07/28/2005
<br />
<br />7983-41-70 07/28/2004
<br />
<br />EACH OCCURRENCE
<br />
<br />AGGREGATE
<br />
<br />EXCLUDES PROFESSIONAL
<br />LIABILITY
<br />
<br />WORKERS COMPENSATION AND
<br />EMPLOYERS' LIABILITY
<br />8 ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICERlMEMBER EXCLUDED?
<br />If yes, describe under
<br />SPECIAL PROVISIONS below
<br />DO~~essional liability
<br />A
<br />
<br />CA
<br />PA/Fl
<br />MI/MD
<br />
<br />we 311-14-75
<br />WC 311-12-24
<br />WC 311-12-23
<br />
<br />10/16/2003
<br />
<br />10/16/2004 X I wc STATU,-r IOJb"
<br />
<br />3582-10-16 07/28/2004 07/28/2005
<br />(EXCLUDED FROM EXCESS
<br />LIABILITY POLICY)
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT J SPECIAL PROVISIONS
<br />he City of Santa Ana, its officers, agents & employees are named as
<br />nsured's operations.
<br />~dditional Insured applies to General Liability policy only
<br />
<br />I
<br />
<br />UMITS
<br />
<br />EA Ace
<br />
<br />AGG
<br />
<br />NAIC#
<br />
<br />I,OOO,OOC
<br />300,00<
<br />10,OOC
<br />I,OOO,OOC
<br />2,OOO,OOC
<br />2,OOO,OOC
<br />
<br />.
<br />
<br />I,OOO,OOC
<br />
<br />$
<br />
<br />.
<br />
<br />$
<br />
<br />3,OOO,OOC
<br />3,OOO,OOC
<br />
<br />I,OOO,OOc
<br />I,OOO,OOC
<br />I,OOO,OOC
<br />
<br />Additional Insured with regards to
<br />
<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 ENDEAVOR TO MAIL
<br />....lL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
<br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
<br />
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702
<br />
<br />Debbie Uland SANDEE
<br />
<br />OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVe$.
<br />AUTHORIZED REPRESENTAllVE
<br />
<br />COL,,~ -
<br />
<br />@ACOROCORPORATION 1988
<br />
<br />ACORD 25 (2001/08)
<br />
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