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No: LLNL # 88-890 Gal & Risk Department <br /> This certificate is issued to: Lawrence Livermore Laboratory <br /> Physics International Company P.O. Box 808 - L709 <br /> 2700 Merced Street Livermore, CA 94550 <br /> P.O. Box 5010 (415) 422-1542 <br /> San Leandro, CA 94577-0599 <br /> LAWRENCE LIVERMORE NATIONAL LABORATORY <br /> CERTIFICATE OF SELF-INSURANCE <br /> This is to certify that Lawrence Livermore Laboratory is self-insured for the following coverages: <br /> Type of Coverage Self-Ensured ,Limits <br /> I. GENERAL LIABILITY: <br /> Each OccurrenceS 1 ;000,00'Q' 2 11191 <br /> QQ��rr <br /> Products and Completed Operations Aggregate S CoT H�A TH <br /> Personal and Advertising Injury $ 1 ,00!6 0010T/SERVICES <br /> Other $ <br /> General Aggregate (Bodily Injury & Property Damage) $ 1 ,000,000 <br /> 11. AUTOMOBILE LIABILITY: <br /> Vehicles owned, Non-owned and Hired $ 1 ,000',000 (CSL) <br /> 111. SPECIAL TERMS & CONDITIONS: <br /> Physics International Company <br /> its officers, agents and employees are hereby named as additional <br /> insureds, but only in connection with regards to the attached <br /> Right of Entry Agreement. <br /> The provisions under Paragraph (1) of this Section III., therefore, <br /> shall apply to claims, costs, injuries or damages but only in <br /> proportion to and to the extent such claims, costs, injuries or <br /> damages are caused by or result from the negligent acts or omissions <br /> of Lawrence Livermore National Laboratory, its officers, agents, or <br /> employees. <br /> Should any of the above described programs of self-insurance ified or cancelled before the expir- <br /> ation date shown below, Lawrence Livermore National Labor ry ill give 30 days ori n notice to the <br /> named certificate holder. <br /> DATE ISSUED: May 22, 1990 <br /> AUTHORIZED SIGNATURE <br /> CERTIFICATE EXPIRES: October 1, 1990 Richard Dyer, Legal & Risk Coordinator <br />