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a� 12/2MIDD/YYYY} CERTIFICATE OF LIABILITY INSURANCE z/21/zoo9 PRODUCER (949)486-7917 FAX: (949)486-7957 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Patriot Risk and Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1 'r nse #OG55454 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 81:-0' Irvine Center Dr. #400 j Irvine CA 92618 j INSURERS AFFORDING COVERAGE NA}C _.._ _ ._.---- ------- INSURED IINSURER A.Char' is Spe_aialtyrI_—ns_Co 126883 Wayne Perry, Inc. 41NSURER B:Commerce & Industry Ins-Co x19410 8281 Commonwealth Ave. IINSURER C:SeaBright Insurance Company !155563— INSURER D: -._._.-------'---...._-_------ Buena Park CA 90621 1 INSURER E: - — COVERAGES 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 OFSUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ ItdSR DD' -��POLI CY EFFECTIVE POLICY EXPIRATION LTR u- - TYPE E POLICY NUMBER _ ;DATE MWDD/YYYY DATE MIDD -+'-_�_-•-- LIMITS GENERAL LIABILITY I I EACH OCCURRENCE $ 1 OOO 000 I 1 ' MG� L"£ TE X COMMERCIAL GENERAL LIABILITY PREISgSEg.qq..un ence) � 1001000 A X _J CLAIMS MADE X OCCUR PROP1665078 ;12/31/2009 12/31/2010 I MEDD_EXP(AD.oneperson) PERSONAL&ADV INJURY $ 11000,000_ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP POLICY 11"i]PRO- I LOC I. V AUTOMOBILE LIABILITY i COMBINED BItDSINGLE LIMIT I$—-1,000^000 ( 1 X ANY AUTO _ B I ALL OWNED AUTOS aA6691454 12/31/2009 12/31/2010 - BODILY INJURY SCHEDULED AUTOS (Per person) $ i X i HIRED AUTOS I ' BODILY INJURY 1 X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY I AUTO ONLY-EA_ACCIDENT_ $ _ ANY AUTO { OTHER THAN _ EA ACC $ AUTO ONLY: AGG $ I EXCESS I UMBRELLA LIABILITY j EACH OCCURRENCE_—_ $ 5 000„000 X OCCUR C CLAIMS MADE i AGGREGATE —�-_ $ 5,000,000 i -- A DEDUCTIBLE 7340721 12/31/2009 12/31/2010 X RETENTION $ 10,000 C WORKERS COMPENSATION `y) WC STATU- I OTH- AND EMPLOYERS LIABILITY �1_T'QRy j llTS_:_a ___...— ANY PROPRIETOR/PARTNERIEXECUTiVE f !E.L. ACCIDENT __ $ 1,000,000 OFFICERIMEMSER EXCLUDED? - --'-'-----' _ (Mandatory in NH) BIIO1086 1/1/2010 1/1/2011 jE.L.DISEASE-EA EMPLOY£- $_'_1- QO 000�O N yes,describe under --_ I - SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT}$ 1000000 A OTHER Pollution & ROP1665078 112/31/2009 12/31/2010 iLimit: $1,000,000 Professional i Each Claim Liability } DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Re: All California operations of the Named Insured. Certificate Bolder is named as Additional Insured on the General Liability per endorsement 78025 0501. Pollution and Asbestos are included under the General Liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TRC Solutions DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN Attn: Grant Ratkovic NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 21 Technology IMPOSE NO OBLIGATION OR LIA81LITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR Irvine, CA 92618 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Gary Hamilton/ANNY ACORD 25(2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. tNS025(200900 The ACORD name and logo are registered marks of ACORD