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<br />~CORD," CERTIFICATE OF LIABILITY INSURANCE \ DATE (MM/DDfYYYYl
<br /> 01/30/2009
<br />PRODUCER (925)688-0733 FAX (925)688-0737 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Westport & Associates Insurance Services, Ine. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />License #OB84505 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
<br />1390 Willow Pass Rd., #930 N -:J-OcJt;,-Ocn
<br />Concord, CA 94520-5253 INSURERS AFFORDING COVERAGE NAIC#
<br />INSURED Downey Vendors, Ine. / Eagle Vending, Inc. INSURER A Travelers Indemn Company of CT
<br /> DBA: aka: Premier vending Group INSURER B
<br /> 6814 Suva Street A .XDl- Qd-6 INSURER C
<br /> Bell Gardens, CA 90201 " " OdS!\ INSURER D:
<br /> INSURER E:
<br />COVERAGES - 0.;1 P,
<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.'1:i TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLlCY EXPIRATION LIMITS
<br /> GENERAL LIABILITY 6601430C75209 02/09/2009 02/09/2010 EACH OCCURRENCE $ 1,000,001
<br /> ~ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED .., $ 100,000
<br /> \ CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $ 5,001
<br />A PERSONAL & ADV INJURY $ 1,000,000
<br /> f-- 2,000,001
<br /> GENERAL AGGREGATE ,
<br /> f-- 2,000,001
<br /> GEN'l AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $
<br /> h ,nPRO. n
<br /> POLICY JECT LOC
<br /> ~TOMOBllE LIABILITY BA3395C09509 02/09/2009 02/09/2010 COMBINED SINGLE LIMIT
<br /> (Eaaccident) $ 1,000,001
<br /> - ANY AUTO
<br /> ALL OWNED AUTOS ., ~ BODILY INJURY
<br /> X $
<br /> SCHEDULED AUTOS ,.O~ (Per person)
<br />A rx
<br /> HIRED AUTOS ..., ~ ~. BODILY INJURY
<br /> ex " (Per accident) $
<br /> NON-OWNED AUTOS ,
<br /> f- t....)
<br /> I- /, ,L~ PROPERTY DAMAGE $
<br /> .,J ~- - ." (Per accident}
<br /> GARAGE LIABILITY oiL' j) ::,.'~",'\'~ AUTO ONLY - EA ACCIDENT $
<br /> ~ ANY AUTO ~~ ,~' [) .~" . EA Ace $
<br /> ~'I> :'c"\" OTHER THAN
<br /> 1// AUTO ONLY AGG $
<br /> :=JESS/UMBRELLA LIABILITY CUP3619Y ~~ L~/09/2009 02/09/2010 EACH OCCURRENCE $ 5,000,001
<br /> OCCUR 0 CLAIMS MADE AGGREGATE $
<br />A $ 5,000,001
<br /> g DEDUCTIBLE $
<br /> X RETENTION $ 1O,00( ,
<br /> WORKERS COMPENSATION AND IACRUB1215L86708 04/01/2008 04/01/2009 I WC STATU-_ I \OJ,tI-
<br /> EMPL.OYERS' L.IABlLlTY 1,000,001
<br />A ANY PROPRIETOR/PARTNERIEXECUTIVE E.l EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED? E L DISEASE - EA EMPLOYEE $ 1,000,000
<br /> If yes, describe under EL DISEASE - POLICY LIMIT 1,000,000
<br /> SPECIAL PROVISIONS below $
<br /> OTHER
<br />DESCR1PTlfN OF OPERATIONS {lOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
<br />ity 0 Santa Ana, its officers, employees, agents, representatives & volunteers are named as
<br />"dditional insured as respects to general liability subject to the conditions, 1 imitations
<br />Fonditions, limitations and exclsuions of the policy.
<br />bl0 Days notice for non-payment of premium.
<br />
<br />s
<br />
<br />City of Santa Ana
<br />20 Civic Center Plaza, M-30
<br />Santa Ana, CA 92702
<br />
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WIL.L ENDEAVOR TO MAIL.
<br />*30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
<br />BUT FAILURE TO MAil SUCH NOTICE SHALL IMPOSE NO OBLlGA liON OR LIABILITY
<br />OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
<br />AUTHORl REPRESENTA nVE
<br />'C.r/loL<."... If? -/It.
<br />@ACORDCORPORATION1988
<br />
<br />ACORD 25 (2001108)
<br />
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