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CENTR-3 <br />ACORD- CERTIFICATE OF LIABILITY INSURANCE <br />DAT3/23/DD/YYYY) <br />3/23/2010 <br />PRODUCER <br />Wells Fargo Insurance Services USA, Inc <br />1401 South Brentwood Boulevard, Suite 625 <br />St. Louis, MO 63144 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURED Keefe Commissary Network, LLC <br />10880 Linpage PlaceINSURER <br />^ <br />"rl0/6 <br />(/�J <br />St. Louis, MO 63132 `� A <br />INSURER a Great Northern Insurance Company (Chubb) 20303 <br />B: Federal Insurance Company 20281 <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />v 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 />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />LTR <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE M <br />A <br />GENERAL LIABILITY <br />7321-00-90 <br />01/01/10 <br />01/01/11 <br />EACH OCCURRENCE $ 1,000,000 <br />DAMAGE TO RENTED $ Included Ea oc;currencel <br />X COMMERCIAL GENERAL LIABILITY <br />MED EXP (Any one person) $ 10,000 <br />CLAIMS MADE Fx-1 OCCUR <br />PERSONAL & ADV INJURY $ 1,000,000 <br />GENERAL AGGREGATE $ 2,000,000 <br />GEN'LAGGREGATELIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG $ 2,000,000 <br />POLICY JEX LOC <br />B <br />AUTOMOBILE LIABILITY <br />7321-00-92 <br />01/01/10 <br />01/01/11 <br />COMBINED SINGLE LIMIT <br />$ 1.000,000 <br />(Ea accident) <br />X ANY AUTO <br />BODILY INJURY $ <br />ALL OWNED AUTOS <br />(Per person) <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />BODILY INJURY $ <br />(Per accident) <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE LIABILITY <br />1 <br />FORM <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EA ACC $ <br />ANY AUTOr <br />1 U <br />AUTO ONLY: AGG $ <br />EXCESSlUMBRELLA LIABILITY <br />Depu <br />City Attorney <br />EACH OCCURRENCE $ <br />OCCUR � CLAIMS MADE <br />AGGREGATE $ <br />$ <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />X WC STATU- OTH- <br />B <br />WORKERS COMPENSATION AND <br />7165-55-50 <br />01/01/10 <br />01/01/11 <br />E.L. EACH ACCIDENT $ 1,000,000 <br />EMPLOYERS'LUIBILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000 <br />E.L. DISEASE -POLICY LIMIT $ <br />If yes, describe under1,000,000 <br />SPECIAL PROVISIONS below <br />OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />80-02-2367 8/04 Certificate holder shown below is included as an Additional Insured as respects General Liability coverages shown regarding operations of <br />the named insured. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br />City of Santa Ana NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />Attn: Purchasing Department IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />20 Civic Center Plaza REPRESENTATIVES. <br />Santa Ann, CA 92701-4010 AUTHORIZED REPRESENTATIVE <br />9� <br />&rtnan qs rgnnvnRl 4 —6-j 1273713 © ACORD CORPORATION 198E <br />(This certificate replaces certificate# 1054410 issued on 12/2212009) <br />