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r <br />ALLIANT <br />License Number: OC36861 <br />Phone (949) 756-0271 / Fax (949) 756-2713 <br />Certificate Number: 37 Date: 1/26/09 <br />VENDOR / CONTRACTOR LIABILITY PROGRAM <br />Named Insured: VIDEO ENGINEERING SERVICES- TOM BYSTRY <br />Address: 3022 PALMYRA AVE. <br />City/State/Zip: ORANGE, CA 92869 <br />Additional Insured: CITY OF SANTA ANA <br />Contract Term: From: 01/31/09 to 01/31/10 <br />Description of Contract: VIDEO EQUIPMENT MAINTENANCE AND USE <br />Contract Amount: $99,660 <br />COMMERCIAL GENERAL LIABILITY — NEW OCCURRENCE FORM <br />General Aggregate: $2,000,000. <br />Products/Completed Operations Limit: $1,000,000. <br />Personal Advertising: $1,000,000. <br />Each Occurrence: $1,000,000. <br />Fire Damage: $ 300,000. <br />Medical Payments: $ 5,000 <br />IMPORTANT! <br />Coverages are Limited to described contract. <br />DEDUCTIBLE: $1,000. Each Claim, Including Legal and Adjustment Expenses <br />ANNUAL PREMIUM: $ 1,994.00 Fully Earned at Inception <br />SURPLUS LINES TAX: $ 64.31 Fully Earned at Inception <br />POLICY FEE: $ 60.00 Fully Earned at Inception <br />TOTAL $ 2,118.31 <br />COMPANY: CATLIN SPECIALTY INSURANCE COMPANY <br />THIS COMPANY BINDS THE KIND(S) OF INSURANCE STIPULATED HEREON. THIS <br />INSURANCE IS SUBJECT TO THE TERMS, CONDITIONS, AND LIMITATIONS OF THE POLICY <br />OF MASTER POLICY # 0400302366 ISSUED TO VENDORS/CONTRACTORS LIABLITY GROUP. <br />A COPY OF THIS POLICY IS AVAILABLE ON REQUEST. <br />THIS CERTIFICATE MAY BE CANCELLED BY THE INSURED BY SURRENDER OF THIS BINDER OR BY WRITTEN <br />NOTICE TO THE COMPANY STATING WHEN CANCELLATION WILL BE EFFECTIVE. THIS CERTIFICATE MAY BE <br />CANCELLED BY THE COMPANY BY NOTICE TO THE INSURED IN ACCORDANCE WITH THE POLICY CONDITIONS. <br />AUTHORIZE SIGNATURE/CO TERSIGNATURE <br />R.E. CHAIX & ASSOCIATES INSURANCE BROKERS ,INC. <br />License Number: 0726213 <br />41 Corporate Park, Suite 310, Irvine, CA 92606 <br />PHONE (949)722-4177 / FAX: (949)722-4172 <br />