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DATE (MM /DD /YYYY) ACORN ERTIFICATE OF LIABILITY INSURANCE 02/09/2011 PRODUCER g25 . 9- 34.0505 FAX 925.977. 1591 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Insurance Associates of Northern CA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1550 Parkside Drive, Suite 120 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Walnut Creek, CA 94596 ?[��! «� ';2 AFFORDING �{/f�� ?r�_, � NAIC # - - - -- INSURED Downey Vendors , Inc . INSURER A' _ ravel ers Prop Cas Co of Amery a -- — 6814 Suva Street C`T� "' - -�� J` I "-*'�" � IIJ$LIFxER �Y . { . 3 , r-c - _ - Bell Gardens, CA 90201 ,'� RE reat Ame h` InsuranceJC -� I I INSURER E- Rf1VFRA!_FC 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 LTR OD' NSR -- TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTVE DATE MM /DD/YYYY POLICY EXPIRATION DATE MM /DDMlYY LIMITS Santa Ana, CA 92702 GENERAL LIABILITY I6601430C752TIL11 02/09/2011 02/09/2012 EACH OCCURRENCE $ 1, OOO, OO COMMERCIAL GENERAL LIABILITY -6AATAC'E T613ENTEI� PREMISES (Ea occurrence) _ X _._ $ _ lOO , OO _� CLAIMS MADE n OCCUR MED EXP (Any one person) $ i , OO A _ _ PERSONAL & ADV INJURY $ 1 , OOO , OO GENERAL AGGREGATE ___ -. $ 2 , OOO , OO GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ Z , OOO , OO X POLICY PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea eccitlenl) $ - BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS (Par person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per eccitlent) PROPERTY DAMAGE $ (Par accitlanQ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ EA ACC OTHER THAN ____ ANY AUTO $ _._. AUTO ONLY'. qGG $ EXCESS /UMBRELLA LIABILITY SBU01992 3 SOO 02/09/2011 02/09/2012 EACH OCCURRENCE $___ S , OOO , OO X OCCUR n CLAIMS MADE _ _ AGGREGATE _ $ S , OOO , OO B DEDUCTIBLE $ X RETENTION $ 1!^ , OO.. $ WORKERS COM PENSATON IJUB1215 L86710 04/01/2010 04/01/2011 X TORY LIMITS ER AND EMPLOYERS' LIABILITY E.L. EACH ACCIDENT --- - - --- — - $ 1 , OOO,.00 A ANY PROPRIETOR/PARTNER/EXECUTIVE� OFFICER/MEMBER EXCLUDED ? (Mandatory In NH) -- -- - - E.L. DISEASE EA EMPLOYEE ---- - -- - -' - ' $ 1 , OOO, OO If yes, tlascribe untler SPECIAL PROVISIONS below - -- -_ -- _ - -- -- -- E.L. DISEASE - POLICY LIMIT _ ---- - - - - -- $ 1 , OOO , OO OTHER �g1� DESCRIPTION OF OPERATONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS ity of Santa Ana is named as additional insured per attached form #CG20110196. PS �,Y Y � Sa�a� `� ��oR.ey *10 Da for a ment non- a ment of remium OS � ��y Al.VR1.I C� \GVV� /VlJ lJ 1i00 -GV V� AlrVR1..I liVRrVRA1IVIY. A11 rlgfliS reSBrvBO. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESC OLICIES 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 Cl ty Of Santa Ana IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 20 CIVIC Center, 8th Floor REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Santa Ana, CA 92702 Stace Smith SSMITH Al.VR1.I C� \GVV� /VlJ lJ 1i00 -GV V� AlrVR1..I liVRrVRA1IVIY. A11 rlgfliS reSBrvBO. The ACORD name and logo are registered marks of ACORD