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UN MANM INC <br /> 11R/Qg CERTIFICATE OF INSURANCE # 10M Pagetofa <br /> hEvidencing Mmment of Mswmce <br /> olr Agent: Mid Central Valley insurance Produc us. <br /> i 0. Bwt 5 301 South t�Lane.Suite E <br /> Under.CA 95235 Ludt,SA 95241 <br /> j C.adricate is effecdva 12:01 ANI 11/01/05 to 12:01 AM 02!11/06 unless cancelled or replaced by the•Poitcy. <br /> Policy is effective: 12:01 AM 11/01/05 to 17-01 AM 11/01/0 <br /> This is to certify that In icoordance with$bur instructtons:WMM-56C}1RrrY-SURPLUS has reaelve�? ee that _ <br /> coverage has ban phuxd with: <br /> COp PWW Great Divide Insurance Company Assigned Policy*C0477602 <br /> Coverage Cornawcbi Genu UaWNty <br /> Form: ISO occurr%nce Form(0,21001 10 01) <br /> Limited Conatoc W(,5007) <br /> i <br /> umits $2,000,000 Genera,Aggregate <br /> S included Ptoducts/ComPleted eons Aggregate <br /> $1,000.000 PeswW&Advertising Injury <br /> 51.000,000 Each OcCurfenae <br /> $100,000 Daae to Premises Rented to You-Any one Premises <br /> 55.000 Madical BVense-Any One Person <br /> Deductib4s $500 per d"sM ind Loss Adjustment Expense <br /> RJCTB4411 70 CI�ub ilc,strrMa��is:$1479 <br /> 1 79 . <br /> or social-no buildings <br /> owned or based- <br /> ft&b/Comp Ops Included <br /> In The General Ag9rs9aN <br /> 10001 5pedd Event _. <br /> 123-2005 01 dw 549.724 Ind. <br /> 05-20-2006 01 Day $72.772 Incl. <br /> 49950 AA-Spacial Event 2 575.00 ea. <br /> conditions •fNq Term: Annual <br /> Tenerbm cmi%ge t*Knd by the Msumd <br /> Scheduled Events: #of Attendees <br /> Date: lEftnt L q*: Event <br /> --� 12.03-2005 1 Day Christmas,m e Ung <501 <br /> j S401006 1 Day <br /> i Attaching Norms: <br /> I SO41 t 00lr fully earned premium-Spedai Dents <br /> 2281 Lava Ridp fit.Suite 340.itw evilly.CA 98661 (918)677-SM Fox(918)677-4494 <br /> Calibrrk License 9 06,8660 <br />