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<br />AcoRaM CERTIFICATE OF L1A
<br />BiLtTY INSURANCE Date (MM/ODlYY)
<br />~l,~2D1D
<br />PRODUCER
<br />AOn Risk Insurance Services West, Inc.
<br />707 Wilshire Blvd., Ste. 6000
<br />Los Angeles, CA 90017 7Hi3 CERTIFICATE IS ISSUED AS A MATTER OF iNFORMATiQN ONLY AHD
<br />CONFERS NO RFGHTS UPON THE CERTIFICATE HOLDER. 7HIS
<br />CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
<br />AFFORDED BY THE POLICIES BELOW.
<br />213 630- 3200 INSURERS AFFORDING COVERAGE NAiC #
<br /> INSURER A ACB American InSUranCe Cam an nr367
<br />VatleyCrest Trec Care Services INSURER B: ACE American Insurance Com an s~a~
<br />Location #49270, 70 Chemical Way INSURER G: ACE American Insurance CDm an ~~~
<br />Redwood City, CA 94063 INSURER D:
<br /> INSURER E:
<br />rnveesr_ec
<br />THE POIICIES Of INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERI00 INDICATED, NOTWITHSTANDING
<br />ANY REQUIREMENT, TERM OR CONDITION Of ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFlCATE MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO Alt OF THE TERMS, EXCLUSIONS AND CONDITIONS Of
<br />SUCH POLICIES. AGGREGATE LIMITS SHOWN HAVE BEEN REDUCED BY PAID CLAIMS.
<br />NtNI
<br />LTR ~~
<br />BieRO TYPE OF INSURANCE POLICY NUMBER POLN;Y EFFECTNE
<br />OATS POLICY E7(PIRATNNA
<br />OATS MMN) LIMITS
<br /> GENERAL LW8IUTY EACH OCCURRENCE $1,000,D00.00
<br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
<br />PREMISE6 Ea occurrence 51,~,(tpp,pD
<br /> ctAlMS MADE ~ oGCUR HOO 624525910 04!01!2010 04!01!2011 MED EXP (Anyone person $5.000.00
<br />R X X~4LHaxem PERSON 8 ADV INJURY 51,000,000.00
<br /> X Contr~tual GENERAL AGGREGATE $2,000,000.00
<br /> GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPP ALiG $2,000,D00_DD
<br /> PRO t~
<br />POLICY X JECT
<br /> AUTON~Bq.E LUIBILRY
<br />X ANY AUTO COMBINED SINGLE LIMIT
<br />{Es acddeM) $2,000,000.00
<br /> ALL owNED Auras ISA H08413216 04/01!2010 04/01/2011 BODILY INJURY $
<br />B SCHEDULED AUTOS (Per ~~)
<br /> HIRED AUTOS BODILY INJURY $
<br /> NON-0WNED AUTOS {Per aocidentj
<br /> PROPERTY DAMAGE $
<br /> (Per Arxuienq
<br /> GARAGE LUIBiUTY AUTOONLY - EA ACCIDENT $
<br /> ANY AUTO OTHER THAN EA ACC $
<br /> AUTO OPA.Y: AGG $
<br /> El(CESaAJMBRELLA LL191LITY EACH OCCURRENCE
<br /> )( OCCUR CLAIMS MADE AGGREGATE ~-
<br /> {fdbxre torm) -.
<br /> DEDUCTIBLE
<br /> RETENTION $10,OW
<br /> WORKERa' COMPENSATN)N ANO
<br />EMPLOYERa' LIABILITY WLR C45575T6T 04101!2010 04!01!2011 X we srwiu•
<br />roRr Uwxre one
<br />~
<br />C ANY pROPRIETOWPARTNERlEXECUTiV£ E.L. EACH ACCIDENT $1,000,000.0{)
<br /> OFFICERlMEMBER EXCtUDED'i
<br />Ir yea, desa~N+s wider E..L DISEASE- EA
<br />EMPLOYEE $1,000,000.00
<br /> sPEaAL PROtinsloNS BEtow
<br />E.L.DiSEASE-POLiGYLiM1T
<br />$1,000,000.00
<br /> OTHER {{
<br />oEacRIPnDN ov DPERATIONa I LOCATIONS r vEH>ctES r ExcwaroNa AtlDED BY ENOi1REEMEttr / aPECW. Pi10viSNlNa ,
<br />#492700881 -The City of San Leandro Bid #09.10.025 Various LocatiGns, San Leandro, CA.
<br />S~ attached fa AddiClGnal irtalJred, Primary, WOS WC
<br />CERTIFICATE HOLDER CANGEtLAitON
<br />Gtty of San Leandro
<br />Rnanea Dlviston
<br />835, East 14th Strsst, 2nd ft
<br />San tasl~dro, GA 94577
<br />3HOUL0 ANY OF Tt~
<br />E%PfRATd6N OATS TI~REOF, THE 1354AN8 (XIWWANY LV91 Et~tYOR TO MAN.
<br />31}DAYS WRITTEN NOTICE TO THE CERTiF4CATE HOLDER NAA9ED TO THE LEFT,
<br />9UT FAN.URE 70 MAq, SUCH NDT}GE SMALL IMPOSE NO D~IGATMJl1 dt
<br />L5a91LiTY OF ANY KN~ UPON THE rANY, ITS AGENT OR REPRESEMTATNES.
<br />AUTHORIZED REPRESENTATRtE
<br />THE
<br />thus.`fey%f/~.luaut~r~tr`e,~~urCc'.t 11~°a1, ,%us
<br />sae
<br />
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