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4 C� -09.5 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (415) 788 -9810 FAX: (415) 248 - 353314 I1 ISU /San Francisco L "It �`t 201 California St., Suite 200 License # 0778092 CIS` San Francisco CA 94111 - 5098 ° -" THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION j OLDE . THIS OCERTFIICATER DOES NOT OAMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. LNS'U. 0 AFFORDING COVERAGE NAIC # INSURED THERMOTEST, INC. 600 MARTIN AVENUE, SUITE 206 ROHNERT PARK CA 94928 INSURER A. Valley Forge Ins Co 20508 INSURER B: Continental Ins Co 20443 INSURER a National Fire Ins Co. 20478 INSURER D INSURER E OVERAGES THE POLICIES OF INSURANCE LISTED BELOW 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 L ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MM/DD1Y LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 7OCCUR 4017886232 12/10/2010 12/10/2011 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY X JECOT LOC PRODUCTS - COMP /OP AGG $ 4,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 4017886232 12/10/2010 12/10/2011 COMBINED SINGLE LIMIT (Ea accident) S 1,000,000 BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO I 7 T77 1 ( 1,711 J 1 AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG S B EXCESS/UMBRELLA LIABILITY X OCCUR 1-1 CLAIMS MADE DEDUCTIBLE RETENTION $ _. I,: '�.bSiiC2;.�if 4017887557 =_ :I _ t- 12/10/2010 r, 12/10/2011 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 S $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER/MEMBEREXCLUDED? If yes, describe under SPECIAL PROVISIONS below 4017886327 12/10/2010 12/10/2011 X TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEES 1,000,000 E.L. DISEASE - POUCY LIMIT $ 1,000,000 A OTHER Contractors Equi -PMt 4017886232 12/10/2010 12/10/2011 65,000 DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS The City of Santa Ana, its officers, agents, employees, Consultants, special counsel, and representatives are named additional insureds if required by written contract. Coverage is primary. .. r f1VLUCR CANCELLATION Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M -30) P.O. Box 1988 Santa Ana, CA 92702 -1988 INS025 (0108).08a SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Richard Alesna /RICHA �' ew_4-_ � © ACORD CORPORATION 1988 Page 1 of 2