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ACORD CERTIFICATE OF LIABILITY INSURANCE °ATE(MM,DD/YYYY) 04/08/2009 PRODUCER 925.688.0733 FAX 925.688.0737 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Westport & Associates Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License #0684505 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW 1390 Wi 11 ow Pass Rd . , #930 ~/~ ~Q ~, ~ 9, . I Concord, CA 94520-5253 INSURERS AFFORDING COVERAGE NAIC # INSURED Downey Vendors, Inc. /Eagle Vending, Inc. INSURERA: Travelers Indemn Company of CT DBA: aka: Premier Vending Group INSURER B: 6814 Suva Street INSURER C: Bell Gardens, CA 90201 INSURER D: INSURER E: vv Y CRMV CJ i nt rvu~lts yr Irv~uwvrvGt us l tD 6ELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR DD' NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YYYY POLICY EXPIRATION DATE MMlDDIYYYY LIMITS GENERAL LIABILITY 6601430075209 02/09/2009 02/U9/201U EACH OCCURRENCE $ 1 ~ QQQ ~ QQ X COMMERCIAL GENERAL LIABILITY PREMISES Ea occur ante $ 100, 000 CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 5 ~ QQQ A PERSONAL & ADV INJURY $ 1 QQQ QQQ ~ ~ GENERAL AGGREGATE $ 2 QQQ QQQ GEN'L AGGREGATE LIMIT APPLIES PER: PRO- PRODUCTS -COMP/OP AGG ~ ~ $ 2 , QQQ ~ QQQ POLICY JECT LOC AUT OMOBILE LIABILITY BA3395C09509 02/09/2009 02/09/2010 X ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ 1 000 00 , , ALL OWNED AUTOS - 1 ~©~1~ A X SCHEDULED AUTOS pp v ~Pi~ Ll-x ~~~ A BODILY INJURY (Per person) $ X HIRED AUTOS ~ '~~ X NON-OWNED AUTOS ~-. ,~ "` BODILY INJURY (Per accident) $ - -,~_.- ' ' , t s aura 5~:: a,.u C J . L ~,1?;f IiLL ~LLlv'~~ PROPERTY DAMAGE (per accident) $ Iyt~~;~ GAR AGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY CUP3619Y73609 02/09/2009 02/U9/201U EACH OCCURRENCE $ 5 ~ QQQ ~ QQQ OCCUR ~J CLAIMS MADE AGGREGATE $ A $ 5,000,000 DEDUCTIBLE $ X RETENTION $ lO, OO WORKERS COMPENSATION AND EMPLOYERS' LIABILITY IACRU61215 L86709 04 Ol / /2009 04/01/2010 $ Y ~ N TORY LIMITS ER A OFFICER/MEMBER EXCLUDED? ECUTIVE^ E.L. EACH ACCIDENT $ 1 ~ QQQ ~ ~~~ (Mandatory in NH) If yes, describe under E.L. DISEASE - EA EMPLOYEE $ 1, QQQ ~ QQ SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 1 ~ QQQ ~ QQQ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS ity of Santa Ana, its officers, employees, agents, representatives & volunteers are named as dditional insured as respects to general liability subject to the conditions, limitations onditions, limitations and exclsuions of the policy. ~10 Da s notice for non- a ment of remium. r_FRTIFICeTt= unl nco . _ --_-. _ _ -_ _ _ _ City of Santa Ana 20 Civic Center Plaza, M-30 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ° 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR TION. 1 ne rr,wKU name ana logo are registered marks of ACORD