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~`~ °® CERTIFICATE O F LIABILITY INSURANCE DATE (MAAIDD/YYYY) 7/8/2009 PRODUCER (925) 688-0733, Fax (925) 688-0737 Westport & Associates Insurance Services, Inc. License #OB84505 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1390 Willow Pass Rd., #930 Concord CA 945205253 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA:TravelerS Indemn Company of Downey Vendors , Inc . / Eagle Vending, Inc . INSURER B: DBA: aka : Premier Vending Group INSURER C: 6814 Suva Street INSURER D: Bell Garldens CA 90201 INSURER E: RAGES COVE THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ANY REQUIREMENT , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OFSUCH MAY PERTAIN , POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR DD' N RD PE FI RAN E POLICY NUMBER DATECMM DOC/YYYY DATE MMIDD/YYYY LIMITS GENERAL LIABILITY 6601930075209 02/09/2009 02/09/2010 EACH OCCURRENCE $ 1 000 000 DAMAGE TO RENTED 100 000 X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence $ A CLAIMS MADE U OCCUR MED EXP (Any one person) $ 5 000 PERSONAL & ADV INJURY $ 1 000 000 GENERAL AGGREGATE $ 2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPlOP AGG $ 2 000 000 POLICY PR~ LOC AUT OMOBILE LIABILITY A3395C09509 02/09/2009 02/09/2010 COMBINED SINGLE LIMIT 00 000 O $ 1 (Ea accident) , , R - ." ANY AUTO - _~.: _ _ _..... _.:._._. .. __ . A ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) ,' -.~a ~o X HIRED AUTOS ~1=, A~ T BODILY INJURY $ X NON-OWNED AUTOS _, o O (Per accident) "lYl PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY ,~SS Z (lt( ~~.GO AUTO ONLY-EA ACCIDENT $ ANY AUTO , gCBnI. (-~~(V - '`~(I.O (' a OTHER THAN EA ACC $ . , ~e~ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY UP3619Y73609 02/09/2009 02/09/2010 EACH OCCURRENCE $ 5 000 000 OCCUR ~ CLAIMS MADE AGGREGATE $ $ 5 000 000 A DEDUCTIBLE $ X RETENTION $ 10,000 $ A WORKERS COMPENSATION IACRUB1215L86708 04/01/2008 04/01/2009 WCSTAiT- OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE ~ E.L. EACH ACCIDENT $ 1 000 000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 1 000 000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 1 000 000 OTHER DESCRIPTION OF OPERATIONS /LOCATIONS 1 VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS City o£ Santa Ana, its officers, employees, agents, representatives 6 volunteers are named as additional insured as respects to general liability subject to the conditions, limitations and exclusions of the policy. *10 Days notice for non-payment of premium. t~ rr~~ ~1~1~ .~~~~7 GtK11FIGAltFiVLUtK ciTi' `- m~ /1-LIV liA1YL.CLL.AIIVIY SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Clty of Sant ~~ ~~ O ~ ~{1 ~~~ DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN 20 Civic Cen er laza, M- NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Santa Ana, CA 92702 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR ACORD 25 (2009/011 AUTHO D REPRESENTATIVE © 1988-2009 ACORD CORPORA INS025 (zoosot) The ACORD name and logo are registered marks of ACORD