GIS DATA RESOURCES, INC. 1E - 2011

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GISDA-2 OP ID: AS .d►c c�Ro CERTIFICATE OF LIABILITY INSURANCE DAT11/08 OM^!Y) 1 /OS/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER 415-661-6500 ONTACT NAME: CAL Insurance & Associates Inc License #0241094 415-661-2254 2311 Taraval Street San Francisco, CA 94116-2253 .foe DeLucchi Renewal PHONE FAX A/C No E:t : C. E-MAIL ADDRESS: _ INSURERS AFFORDING COVERAGE NAIL 0 INSURIERA:Valley Forge Insurance Co. 20508 INSURED GIS Data Resources, Inc. INSURER B :American Calls. Co of Reading PA 20427 101 Lucas Valley Rd Ste 200 San Rafael, CA 94903 INSURER C: Continental Casualty Company 20443 ---- INSURER D : INSURER E INSURER F C(-1VPMAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM DDfYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X_ GENERAL LIABILITY X 4019896305 10/29/11 10/29/12 PREMISES Ea occurrence $ 1 OD,00 _COMMERCIAL ICLAIMS -MADE I -XI OCCUR MED EXP (Any one Person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: TS - COMP/OP AGG $ 2,000,00 mB $ 1,000,00X POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accitlenf $ 11000100 BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NONSWNED 4019B963 8 SSA M. CR 10/ 9/11 O 1 O/29/12 E BODILY INJURY (Per accident) $ PPeOr acEUCen^DAMAGE $ STHWA[ $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 C EXCESS LIAB CLAIMS -MADE 4019896353 10/29/11 10/29/12 DED I X I RETENTION $ 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 4019896255 10/29/11 10/29/12 X WC STATUOTH- LIM T- E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 40 If ........ ribe und.r DESCRIPTION OF OPERATIONS belo•.v 1V C J O _y DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101. Additional Remarks Schedule, if more space is required) SANTA ANA FIRE DEPARTMENT, THEIR OFFICERS, DIRECTORS, AND AGENTS ARE NAMED AS ADDITIONAL INSURED PER ATTACHED G144294-C99 — 737 1 J U rJ T> CERTIFICATE HOLDER CANCELLATION rV SANTAAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SANTA ANA FIRE DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 1439 S. BROADWAY SANTA ANA, CA 92707 AUTHORIZED REPRESENTATIVE (� 19B8-2010 ^CORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD