|
<br /> - I
<br />-r.AC1JBa. CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDDIYYYY)
<br /> 07/26/2005
<br />PRODUCER (650)341-4484 FAX (650)341 4465 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Business Professional Ins. Assoc. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />1519 South B Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />San Mateo, CA 9440Z
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br />INSURED Valley Oak Systems Inc. /t~ 1919- M3 INSURER A: Federal Insurance/Chubb Ins.
<br /> 5000 Executive Pkwy., Suite 340 fl- ;i{tJ;! - 035 INSURER B: Granite State Ins. Co
<br /> San Ramon, CA 94583 Ih.< 003- ok. 9 INSURER c:
<br /> 4 - .:2.ro5- 0 7.2- INSURER 0-
<br /> INSURER E:
<br />"nV"RA''''''
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABove FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
<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 />II~":- ~p.,<~ TYPE OF INSURANCE POLICY NUMBER PPH.g,v EFFECTIVE POLICY EXPIRATION LIMITS
<br /> ~NERAL UABILlTY 3582-10-16 PLE 07/Z8/Z005 07/28/2006 EACH OCCURRENCE S 1,000,000
<br /> -.! ~ERCIAL GENERAL LIABILITY DAMAGE TO RENTED S 1,000,000
<br /> _ CLAIMS MADE [!] OCCUR MED EX? (Ivry one person) S 10,OO(
<br />A PERSONAl & ADV INJURY S 1,000,001
<br /> GENERAL AGGREGATE S Z,OOO,OOl
<br /> ~~ AGGREGATE LIMIT APnS PER: PROOUCTS-COM~OPAGG S 1,OOO,OO(
<br /> (nPRO.
<br /> POLICY JECT LOC
<br /> ~OMOB1LE LIABILITY 7499-64-69 07/28/2005 07/28/2006 COMBINED SINGLE LIMIT
<br /> (Eaaecidenl) S 1,OOO,Ooc
<br /> 7 ANY AUTO
<br /> ALL OWNED AUTOS BoalL Y INJURY
<br /> e.::- (Per person} S
<br />A 7 SCHEDULED AUTOS
<br /> HIRED AUTOS BODILY INJURY
<br /> i (Perao::ident) S
<br /> ~ NON-OWNED AUTOS
<br /> - PROPERTY DAMAGE S
<br /> (Per accident)
<br /> ;=rDE LlABIUTY AUTO ONLY. EA ACCIDENT S
<br /> ANY AUTO OTHER THAN EAACC S
<br /> AUTO ONLY. AGG S
<br /> 5~SSJUMBRELLA lIABIUTY 7983-41-70 07/Z8/2005 07/28/Z006 EACH OCCURRENCE S 3,000,000
<br /> OCCUR 0 CLAIMS MADE AGGREGATE S 3,000,000
<br />A EXCLUDES PROFESSIONAL s
<br /> Fxi DEDUCTIBLE LIABILITY S
<br /> X RETENTION S 10, OOC s
<br /> WORKERS COMPENSAnON AND CA we 9543237 10/16/Z004 10/16/Z005 X I T"X~~m~~ I IOJ~'
<br /> EMPLOYERS' UABIUTY PAlFL WC 9543236 1,OOO,OOC
<br />B ANY PROPRIETDRlPARTNERlEXECUTlVE E.L. EACH ACCIDENT S
<br /> OFFICERlMEMBER EXCLUDED? MI/MO WC 9543235 E.L. DISEASE. EA EMPLOYEE S 1,OOO,OOC
<br /> ~~~~~s~'bV~s,'ONS below E.L. OlSEASE . POLICY LIMIT S 1,OOO,OOC
<br /> OnlY. . Liabil ity 3582-10-16 07/Z8/2005 07/Z8/2006 $3,000,000
<br />A ro esslonal (EXCLUDED FROM EXCESS $50,000 Deductible
<br /> LIABILITY POLICY)
<br />IJtESCRlPnON OF ~PERATlONS I LOCAnONS' VEHICLES' EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS are named as Additional Insureds
<br />he City 0 Santa Ana, its officers, agents, employees, and volunteers
<br />On respects to insureds business operations.
<br />~dditional Insured applies to General Liability policy only
<br />~10 day notice of cancellation for non payment of premium shall apply.
<br />
<br />City of Santa Ana
<br />Jeff Stevens- Risk Mgr.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 9Z701
<br />
<br />1"P,PRO, VED,AS 'TO
<br />
<br />, , I
<br />" I_,,-=-
<br />I \" ' '
<br />ichJd Vig;\lolta
<br />Deputy Cilv'\\lOrncy
<br />
<br />SHOULD ANY OF THE ABOVE DESCRJBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRAnON DATE THEREOF, THE ISSUING INSURER WILL ~ MAlL
<br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOlDER NAMED TO THE LEFT,
<br />7~~1II(1lIOOiltl@OOty..V"~XX
<br />Jll(JIIOOIlOOI~_llllll__ltl."XXXXXXXX
<br />AUTHORIZED REPRESENTATIVE
<br />
<br />le
<br />
<br />1 and SANDEE
<br />
<br />~~
<br />
<br />ACORO 25 (2001/08)
<br />
<br />@ACORDCORPORATION 1988
<br />
|